Over an average 7.2-year follow-up, surgical treatment significantly improved survival compared to medical management in 249 patients with mitral valve disease.
Cohort (n=249)
Does surgical treatment improve late survival compared to medical treatment in patients with mitral valve disease?
Surgical intervention significantly improves long-term survival in patients with mitral valve disease compared to medical therapy, particularly in those with mixed stenosis/regurgitation and moderate ejection fraction impairment.
Late follow-up (average = 7.2 years) has been obtained in 249 patients with mitral valve disease who had quantitative angiographic assessment of left ventricular function at thetime of initial catheterization in the 1960s. Surgically treated patients with mitral valve disease had significantly improved survival as compared to medically treated patients with mitral disease. The subgroup with mixed mitral stenosis and regurgitation and the subgroup with moderate impairment of ejection fraction account for this improved survival in surgically treated patients, which occurred despite greater functional and hemodynamic impairment in the surgical cohorts. Using univariate life table survival analysis, ten variables were found to be predictive of survival in the medical cohort, and three in the surgical cohort. With multivariate Cox's regression analysis, end-diastolic volume and arteriovenous oxygen difference were significantly predictive of survival in the medical cohort; age was predictive of survival in the surgical cohort.
Hammermeister et al. (1978) conducted a cohort in Mitral valve disease (n=249). Surgical treatment vs. Medical treatment was evaluated on Late survival. Over an average 7.2-year follow-up, surgical treatment significantly improved survival compared to medical management in 249 patients with mitral valve disease.