Comparative morbidity of mitral valve repair versus replacement for XXXX with and without coronary artery disease.

@entity1 @entity627 @entity339 @entity63 @entity301 @entity884
Mitral valve repair has been increasingly used at our hospital for @entity339 with and without @entity301 . From January, 1984, to June, 1987, of 338 @entity1 undergoing all forms of mitral valve surgery, 140 had first-time surgery for pure @entity339 : 75 had valve repair, and 65 had valve replacement. Thirty-three of 75 (44%) had concomitant coronary bypass in the repair group, while 21 of 65 (32%) had coronary bypass in the replacement group. The mean functional class (3.4 versus 3.5), age (60 versus 61 years), and preoperative hemodynamics were similar in both groups. The cause of @entity339 in the repair group was myxomatous change in 32 @entity1 , @entity63 in 27, @entity627 in 12, and @entity884 in 4. A Carpentier ring was used in 46, a Duran ring was used in 11, and none was used in 18. The operative mortality was 3 of 75 @entity1 (4%) in the repair group, all with coronary artery bypass grafting, versus 2 of 65 @entity1 (3%) in the replacement group, 1 of whom had undergone coronary artery bypass grafting. The mean postoperative functional class 15 months postoperatively was 1.12 in the repair group versus 1.15 in the replacement group. There were 7 late deaths in the replacement group and only 3 late deaths in the repair group. Actuarial survival at 30 months was 85 +/- 6% for the replacement group and 94 +/- 4% for the repair group. There were 5 late emboli (1 fatal, 4 nonfatal) after valve replacement and none after valve repair (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
