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. 2016 Dec;78(4):369-376.
doi: 10.18999/nagjms.78.4.369.

The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan

Tomonobu Abe  1 , Hideki Ito  1 , Masato Mutsuga  1 , Kazuro Fujimoto  1 , Sachie Terazawa  1 , Yuji Narita  1 , Hideki Oshima  1 , Akihiko Usui  1
Affiliations

The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan

Tomonobu Abe et al. Nagoya J Med Sci. 2016 Dec.

Abstract

Mitral valve surgery has changed with the wide acceptance of mitral valve repair. The aim of this study is to obtain the long-term results of patients who underwent mitral valve replacement (MVR) using a biological prosthesis in contemporary practice in Japan. From January 1990 to December 2013, 76 patients underwent MVR using a biological prosthesis with or without concomitant surgery. Data were obtained by means of a questionnaire and a telephone interview. The mean follow-up period was 4.26 years. The etiologies of the patients included dilated cardiomyopathy (DCM) (n=20 [26.3%]), ischemic mitral regurgitation (n=7 [9.2%]). There is a trend towards decreasing number of rheumatic and degenerative disease and increasing number of DCM and ischemic mitral regurgitation. Three patients (3.9%) died in the perioperative period. The 5- and 10-year overall survival rates were 69.6% and 31.7%, respectively. The 5- and 10-year freedom from valve related death were 95.6% and 80.6 %, respectively. The linearized rates of valve-related complications were as follows: thromboembolism (0.63%/patient/year), bleeding (1.25%/patient/year). One patient underwent reoperation for structural degeneration 13 years after the first operation. The present study shows the long-term results of mitral valve replacement with bioproshtesis in a contemporary case series. The practice pattern is changing. The low rate of valve-related complication justify the current patient selection.

Keywords: Imitral valve replacement; biological prosthesis; long-term results.

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Figures

Fig. 1
Fig. 1
Percentages o each etiology of mitral valve disease for three periods. The numbers in the bars indicate actual number of cases. Rhe, Rheumatic Disease; DCM, Dilated Cardiomyopathy; Ischemic, Ischemic Mitral Regurgitation; IE, Infective Endocarditis
Fig. 2
Fig. 2
A, Freedom from death of any cause; B, Freedom from Valve Related Death
Fig. 3
Fig. 3
Freedom from death of any cause for each etiology DCM, Dilated Cardiomyopathy; Deg, Degenerative; IE, Infective Endocarditis; Isc, Ischemic Mitral Regurgitation SVD, Rhe, Rheumatic Disease
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