FACTORS INFLUENCING LONG-TERM SURVIVAL AFTER MITRAL-VALVE REPLACEMENT

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Abstract
Consecutive cases of mitral valve replacement (37) were retrospectively reviewed. The prognostic significance of preoperative clinical, hemodynamic and quantitative angiographic factors for survival was evaluated. In the mitral stenosis (MS) group, all of the patients who showed small stroke volume index (SVI) (less than 45 ml/m2) with pulmonary hypertension died from the low output syndrome. The prognosis was poor in patients who had a large cardiothoracic ratio (CTR) in the MS group. Aortic valve replacement must be considered when moderate aortic regurgitation is associated with mitral valve disease. In the MR group, left ventricular (LV) wall thickness and ejection fraction (EF) can be good factors for predicting the survival. The eccentricity ratio is also a sensitive parameter for recognizing a patient who will have a poor prognosis after mitral valve replacement. The main mode of death was heart failure due to myocardial impairment.

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