Our Summary

This study examined the long-term results of repairing the mitral valve (MV), a valve in the heart that can degrade over time. The researchers looked at over 1,000 patients who had this repair done at Beijing Anzhen Hospital over a ten-year period. They tracked these patients for an average of almost five years, looking at complications, deaths, and whether the problem with the valve came back.

The study found that 10 patients died in the hospital and 33 died during the follow-up period, while the issue with the valve returned in 113 patients. Only 14 patients needed to have the surgery again. The study found that 94% of patients survived in the long term, 81.2% did not have the valve problem return, and 98.2% did not need another operation.

The study identified several factors that increased the risk of death or the problem returning. These included older age, having a lower heart ejection fraction (which measures how well the heart pumps blood), being female, having a particular kind of heart valve issue (anterior prolapse), having a certain level of the valve problem remain after surgery, and having a lower body weight.

The researchers concluded that repairing the mitral valve is a good treatment for this type of heart valve disease, with low rates of death, the problem returning, and needing another operation. These results highlight the importance of early detection and treatment of degenerative mitral valve disease.

FAQs

  1. What are the long-term outcomes of degenerative mitral valve repair?
  2. What are the risk factors for long-term all-cause death and recurrent mitral regurgitation after mitral valve repair?
  3. What is the effectiveness of mitral valve repair in treating degenerative mitral valve disease based on the study conducted at Beijing Anzhen Hospital?

Doctor’s Tip

A helpful tip a doctor might tell a patient about mitral valve repair is to follow a healthy lifestyle with regular exercise and a balanced diet to maintain overall heart health. Additionally, it is important to attend regular follow-up appointments and adhere to any medication regimen prescribed by your healthcare provider to monitor and manage any potential complications post-surgery.

Suitable For

Patients with degenerative mitral valve disease are typically recommended mitral valve repair. This study found that mitral valve repair is an effective treatment for degenerative mitral valve disease, with low mortality, recurrence, and re-operation rates. Advanced age and an ejection fraction <60% were identified as risk factors for long-term all-cause death, while age, female sex, residual 1+ mitral regurgitation postoperatively, lower body mass index, higher peak E-wave velocity, and anterior prolapse were identified as risk factors for recurrent mitral regurgitation. Overall, mitral valve repair is a recommended treatment option for patients with degenerative mitral valve disease.

Timeline

Before mitral valve repair:

  • Patient may experience symptoms such as shortness of breath, fatigue, palpitations, and chest pain
  • Patient undergoes diagnostic tests such as echocardiogram, cardiac catheterization, and MRI to assess the severity of the mitral valve disease
  • Patient is evaluated by a multidisciplinary team of cardiologists, cardiac surgeons, and anaesthesiologists to determine the best treatment approach
  • Patient undergoes preoperative preparation including medication management, lifestyle modifications, and education on the procedure

After mitral valve repair:

  • Patient undergoes surgery to repair the mitral valve, which may involve techniques such as leaflet repair, annuloplasty, or chordal replacement
  • Patient is closely monitored in the intensive care unit postoperatively for any complications such as bleeding, infection, or arrhythmias
  • Patient undergoes cardiac rehabilitation to improve recovery and strengthen the heart muscle
  • Patient is followed up regularly by the healthcare team to monitor for any recurrence of mitral regurgitation or other complications
  • Long-term outcomes are evaluated, with factors such as age, sex, ejection fraction, and residual MR postoperatively influencing the risk of all-cause death or recurrent MR.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with mitral valve repair surgery?
  2. What is the expected recovery time after mitral valve repair surgery?
  3. How long do the results of mitral valve repair typically last?
  4. What follow-up care or monitoring will be necessary after mitral valve repair surgery?
  5. Are there any lifestyle changes or restrictions that should be followed after mitral valve repair surgery?
  6. What symptoms should I watch for that may indicate a problem with the repaired mitral valve?
  7. Will I need to take any medications long-term after mitral valve repair surgery?
  8. How often should I have follow-up appointments with my doctor after mitral valve repair surgery?
  9. What are the potential risk factors for long-term complications or recurrence of mitral regurgitation after mitral valve repair?
  10. What is the success rate of mitral valve repair surgery in patients with degenerative mitral valve disease?

Reference

Authors: Liu K, Ye Q, Zhao Y, Zhao C, Song L, Liu Y, Bai C, Han J, Wang S, Wang J. Journal: Heart Lung Circ. 2024 Jan;33(1):111-119. doi: 10.1016/j.hlc.2023.11.009. Epub 2023 Dec 30. PMID: 38161084