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February 15, 1995Circulation

Multivariate analysis indicated an independent beneficial effect of valve repair on overall survival compared to valve replacement (hazard ratio, 0.39; P = .00001).

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Why the study?

Does mitral valve repair improve survival compared to mitral valve replacement in patients with organic mitral regurgitation?

Population

409 patients with organic mitral regurgitation

Comparison

Mitral valve repair vs Mitral valve replacement

Design

Cohort

Follow-up

10 years

Authors

MEMaurice Enriquez‐SaranoHSHartzell V. SchaffTOThomas A. Orszulak

Discussion

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Overview

Mitral repair may improve survival vs replacement in organic MR; leaves open need for randomized confirmation.

Key Points

  • To evaluate the effectiveness of mitral valve repair versus replacement on postoperative outcomes for patients with mitral regurgitation.
  • Compared outcomes in 195 patients with valve repair and 214 with valve replacement using multivariate analysis.
  • Preoperative assessment included echocardiographic evaluation of left ventricular function.
  • Analyzed survival rates, operative mortality, and postoperative ejection fraction after 10 years.
  • Overall survival at 10 years was 68% for valve repair vs. 52% for replacement (P = .0004).
  • Operative mortality was significantly lower in the repair group at 2.6% compared to 10.3% in the replacement group (P = .002).
  • Multivariate analysis revealed a beneficial effect of valve repair on overall survival (HR 0.39; P = .00001) and postoperative ejection fraction (P = .001).

Structured PICO

Does mitral valve repair improve survival compared to mitral valve replacement in patients with organic mitral regurgitation?

P
Population
409 patients with organic mitral regurgitation
I
Intervention
Mitral valve repair
C
Comparator
Mitral valve replacement
O
Outcome
Overall survival at 10 yearshard clinical

Mitral valve repair is associated with significantly lower operative mortality and better long-term survival compared to valve replacement in patients with organic mitral regurgitation.

Cite This Study

Enriquez‐Sarano et al. (1995) studied this question.

synapsesocial.com/papers/69f9349f8338827971878a9dhttps://doi.org/10.1161/01.cir.91.4.1022
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