Early and mid-term functional and survival benefits in ischaemic versus degenerative mitral valve repair using Duran flexible ring: a single surgeon series

The late results of ischaemic mitral valve (MV) repair have been less than satisfying. We compared echocardiographically, the changes in LV function, mid-term durability and survival between MV repair caused by ischaemic cardiomyopathy (n=60) with degenerative MV disease (n=73) over a period of 15 years. The duration of mean follow-up was 3.7+/-4.1 years in the ischaemic group and 3.9+/-2.9 years in the degenerative group. Freedom from reoperation at seven years was 98.3%+/-1.5% and 98.9%+/-2.1%, respectively (P=0.889). At the last follow-up, NYHA functional class I or II was present in 78.4% of patients in the ischaemic group and 80.9% patients in the degenerative group (P=0.347). An improvement in LVEF was noted in both the groups: ischaemic--41.3+/-12.7 (pre-op LVEF: 38.8+/-14.1) and degenerative--46.5+/-11.1 (pre-op LVEF: 45.7+/-11.7) (P=0.014). At seven years, freedom from a cardiac cause of death was statistically similar in the two groups: 93.3%+/-1.3% and 92.2%+/-0.6% (P=0.967). In conclusion, the mid-term results of ischaemic MV repair are similar to those obtained for degenerative MV repair. Surgical correction of ischaemic MR results in long-term improved LVEF and comparable outcomes in terms of freedom from reoperation and survival.