Key result
Mitral valve replacement for severe mitral insufficiency post-myocardial infarction had a 33% mortality rate (5/15); all deaths occurred in patients with markedly impaired left ventricular function.
Observational (n=15)
Surgery for severe mitral insufficiency following myocardial infarction had a 33% mortality rate, with deaths occurring exclusively in patients with markedly impaired pre-operative left ventricular function.
High mortality after post-MI mitral replacement when LV function is poor; leaves open optimal selection and timing in prospective studies.
Severe mitral insufficiency following myocardial infarction in 15 patients is reported. The mean interval from infarction to surgery was 2.8 years. All patients were operated on with mitral valve replacement and in 14 aortocoronary bypass and/or resection of left ventricular aneurysm was necessary as well. Rupture of one or more heads of the papillary muscle was found in 5 patients. In another 5 the papillary muscles were discoloured, fibrosed and shortened, and in the last 5 patients the mitral incompetence was caused by a marked dilatation of the atrioventricular ring. Five patients (33%) died, 3 early and 2 late after surgery. All the patients who died had a markedly imparied left ventricular function pre-operatively with end-diastolic pressures from 15 to 26 mmHg.
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Rostad et al. (1979) conducted an observational in Severe mitral insufficiency following myocardial infarction (n=15). Mitral valve replacement was evaluated on Mortality. Mitral valve replacement for severe mitral insufficiency post-myocardial infarction had a 33% mortality rate (5/15); all deaths occurred in patients with markedly impaired left ventricular function.
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