Follow-Up of the Mid-Term Results for Mitral Valve Repair for Rheumatic Mitral Regurgitation

Abstract
Background: Rheumatic mitral valve disease is consider-ably less common in North America and European countries than in developing countries, where rheumatic heart disease remains by far the leading cause of valvular diseases. This study was done to evaluate the midterm results over 10y of mitral valve repair for rheumatic mitral regurgitation in term of survival rate and late valve failure and need of redo surgery.
Aim of Study: To record mid term results over 10y of our trail to repair the mitral valve with rheumatic pathology that caused uncoaptation and regurge in the mitral valve with special attention to the evaluation of the number of patients survived, delayed failure of the repair done and need of redo surgery.
Patients and Methods: This is a retrospective study from January 2004 to January 2014, one hundred and twenty patients with rheumatic mitral valve disease underwent mitral valve repair in our hospital. Age ranged from 15 to 53 years, 80% patients were female. The lesions were pure mitral regurgitation in 95 (79.1%) patients, predominant mitral regurgitation with stenosis in 12 (10%), and predominant mitral stenosis with regurgitation in 13 (10.8%). Ninty patients (75%) patients were in normal sinus rhythm.
Results: Follow-up time ranged from 6 to 120 months, mean 55.4±3.2 months. There were 10 late deaths. Survival at 5 and 10 years was 96.5% and 91.2%, respectively. 25 patients (20.8%) patients had mitral regurgitation during follow-up, and 8 underwent reoperation with no hospital mortality. Freedom from reoperation at 5 and 10 years was 93.5% and 82.7%, respectively. Progression of mitral regur-gitation at 5 and 10 years was 71.4% and 59.3%, respectively. Freedom from all late events at 5 and 10 years was 72.6% and 54.2%, respectively.
Conclusions: Mitral valve repair for rheumatic mitral regurgitation is associated with a significant rate of valve failure and reoperation. However, it has a satisfactory survival rate and is a good alternative to valve replacement, especially for young female patients in child bearing period to avoid the life-long risks of a prosthetic valve and anticoagulation related problems.