Surgery for Degenerative Mitral Valve Disease:Earlier Intervention, New Procedures, and Better Outcomes

Objective: To assess trends in patient characteristics, evolution of surgical techniques for degenerative mitral valve (MV) disease, and effects of these changes on surgical morbidity and mortality and hospital stay.Methods: From 1985 to 2010, 7,982 patients underwent surgery for degenerative mitral regurgitation; 5,045 had isolated MV procedures, including 4,765 repairs and 280 replacements.Results: Compared with earlier years, patients undergoing isolated mitral valve repair are younger and less symptomatic, with preserved cardiac geometry. Use of less invasive and robotic surgical approaches has increased, and more than 90% of patients undergo valve repair. Hospital mortality currently approaches 0%. Postoperative hospital stay decreased significantly. Multivariable analysis shows that higher NYHA class, anemia, renal failure, and higher intraventricular septal thickness are significantly associated with increased postoperative morbidity and longer hospital stay.Conclusions: We now operate earlier on patients with degenerative MV disease, before symptoms or changes in cardiac geometry develop. Hospital results are excellent, supporting early surgical intervention in patients with severe mitral regurgitation caused by degenerative disease.

Name thesis:degree_name

Master of Sciences

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

Clinical Research

Grantor dc:publisher

Case Western Reserve University School of Graduate Studies

Year dc:date

2013

Author dc:creator

• Yazdchi, Farhang

Contributors dc:contributor

• Ralph, O'Brien

• Surgery
• Medicine
• Trends
• degenerative
• mitral

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=case1365172737

OAI identifier oai:identifier

oai:etd.ohiolink.edu:case1365172737