Mitral valve reconstruction versus replacement for XXXX .

@entity1 @entity712 @entity339 @entity101 @entity63 @entity1188 @entity951 @entity1031 @entity397 @entity6151 @entity453 @entity204
Between January 1985 and June 1992, 263 consecutive @entity1 had mitral valve reconstruction (133 @entity1 ) or replacement (130 @entity1 ) for @entity339 . The two groups were similar in sex, age, prior @entity1188 or cardiac operations, @entity101 , @entity951 , and functional class. Both groups were similar in mean ejection fraction, pulmonary artery pressure, cardiac index, and incidence of @entity453 . More reconstruction than replacement @entity1 had @entity63 etiology (22 [16%] versus 12 [9%]; p = not significant), and fewer reconstruction @entity1 had @entity6151 (9 [7%] versus 39 [30%]; p < 0.01). More reconstruction than replacement @entity1 had concomitant cardiac procedures (67 [50%] versus 59 [45%]; p = not significant). @entity204 occurred in 4 reconstruction @entity1 (3%) and 15 (12%) replacement @entity1 (p < 0.01). Median postoperative stay was shorter in reconstruction @entity1 (10 versus 12 days; p = 0.02). Late valve-related @entity204 occurred in 3 reconstruction @entity1 (2%) and 8 (6%) replacement @entity1 (p = 0.08). Six-year actuarial freedom from @entity1031 was 92% for the reconstruction group and 85% for the replacement group (p = 0.12). Freedom from all valve-related morbidity and mortality was 85% for the reconstruction @entity1 and 73% for the replacement @entity1 (p = 0.03). Significant multivariate predictors of @entity204 were age, mitral valve replacement, functional class, @entity712 , no posterior @entity397 , and nonelective operation. Mitral valve reconstruction, when technically feasible, is the procedure of choice for @entity339 because of significantly lower hospital mortality and late valve-related events.
