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. 2020 Mar;109(3):794-801.
doi: 10.1016/j.athoracsur.2019.07.014. Epub 2019 Aug 28.

Degenerative Mitral Valve Repair Restores Life Expectancy

Tessa M F Watt  1 , Alexander A Brescia  2 , Shannon L Murray  2 , David A Burn  3 , Alexander Wisniewski  4 , Matthew A Romano  2 , Steven F Bolling  2 ; Michigan Mitral Research Group (MMRG)
Affiliations

Degenerative Mitral Valve Repair Restores Life Expectancy

Tessa M F Watt et al. Ann Thorac Surg. 2020 Mar.

Abstract

Background: Mitral valve repair (MVr) for severe, degenerative mitral regurgitation is the gold standard, because medical management carries poor prognosis. However, despite clear benefit of MVr, many eligible patients are untreated. This study investigated whether MVr restores patients to normal life expectancy, at any age of operation, by comparing long-term survival of patients after MVr with the life expectancy of the general United States population.

Methods: This retrospective study investigated 1011 patients with degenerative mitral regurgitation who underwent isolated MVr between 2003 and 2017. Parametric distribution analysis was applied to long-term post-MVr mortality data, and Weibull probability plots provided the best-fit distribution by Anderson-Darling Goodness-of-Fit testing. Confidence intervals of the estimated distribution were used to compare additional life expectancy after MVr to the general US population across multiple decades of life. Patients after MVr were categorized by age into decade (range, 20-89 years).

Results: The life expectancy of patients after MVr matched the life expectancy of the general US population at any age between 40 and 89 years. Lower-bound one-sided 95% confidence intervals for additional life expectancy were not appreciably different from corresponding median additional life expectancy of the general population. There were few deaths in the 20- to 39-year-old group, limiting predictability, but survival also appeared normative.

Conclusions: These findings suggest that degenerative MVr restores anticipated life expectancy to that of the general population, regardless of age. Although our findings underscore the importance of repair for degenerative mitral disease, larger studies with longer term follow-up are needed to reinforce this finding, particularly for younger patients.

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Figures

Figure 1.
Figure 1.
CONSORT Diagram of Patient Population
Figure 2.
Figure 2.
Weibull Probability Plots for Life Expectancy by Decade in Post-MVr Patients
Figure 3.
Figure 3.
Additional Years of Life Expectancy by Age Group
Figure 4.
Figure 4.
Kaplan-Meier Survival Analysis of Post-MVr Patients by Decade
See this image and copyright information in PMC

References

    1. Enriquez-Sarano M, Akins CW, and Vahanian A, Mitral regurgitation. Lancet, 2009. 373(9672): p. 1382–94. - PubMed
    1. Singh JP, et al. , Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol, 1999. 83(6): p. 897–902. - PubMed
    1. Goel SS, et al. , Prevalence and outcomes of unoperated patients with severe symptomatic mitral regurgitation and heart failure: comprehensive analysis to determine the potential role of MitraClip for this unmet need. J Am Coll Cardiol, 2014. 63(2): p. 185–6. - PubMed
    1. Nishimura RA, et al. , 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol, 2017. 70(2): p. 252–289. - PubMed
    1. Bonow RO, et al. , 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol, 2008. 52(13): p. e1–142. - PubMed

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