5. Mitral valve replacement for mitral stenosis: 15 years single center experience

This study aimed to evaluate and compare the early and late outcome of mitral valve replacement (mechanical versus bioprosthetic) for severe mitral stenosis. A retrospective cohort study was performed on prospectively collected data involving mitral stenosis patients who have undergone MVR with either bioprosthetic (BMV) (n =50) or mechanical (MMV) (n =145) valves in our institute from 1999 to 2012. Data were analyzed for early and late mortality, NYHA functional classes, stroke, early and late valve-related complications, and survival. Chi Square test, logistic regression, Kaplan Meier curve, and dependent proportions tests were performed. A total of 195 patients were included in the study with a follow-up of 190 patients (97.5%). One patient died early post-operatively; twelve patients died late in the post-operative period, BMV group (6) and the MMV (6). The Late mortality had significantly associated with post-op stroke (p <0.001) and post-op NYHA classes III and IV (p =0.002). Post-op NYHA class was significantly associated with age (p =0.003), pulmonary disease (p =0.02), mitral valve implant type (p =0.01), and post-op stroke (p =0.02); 14 patients had strokes in the MMV (9) and in the BMV (5) groups. NYHA classes were significantly better after the replacement surgeries (p <0.001). Bioprosthetic valves were significantly associated with worse survival (p =0.03), worse NYHA post-op (p =0.01), and more re-operations (p =0.006). Survival was significantly b...
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research