Survival and long-term outcomes after mitral valve replacement in patients aged 18 to 50 years
Samuel R. Schnittman, MD, David H. Adams, MD, Shinobu Itagaki, MD, Nana Toyoda, MD, Natalia N. Egorova, PhD, Joanna Chikwe, MD
OBJECTIVE:
To provide long-term data on survival and major morbidity after mitral valve replacement in patients aged 18 to 50 years.
METHODS:
Retrospective analysis of 2727 patients aged 18 to 50 years who underwent isolated mitral replacement in California and New York from 1997 to 2006. Median follow-up time was 12.4 years (maximum 15.0 years). The primary endpoint was mortality; secondary endopoints were stroke, major bleeding, and reoperation. Propensity matching yielded 373 patient pairs.
CONCLUSIONS:
The significant survival benefit associated with mechanical mitral valve replacement in adults ≤50 years may be due to the practice of implanting bioprostheses in sicker patients or those judged less likely to comply with long-term medication despite adjustment for baseline characteristics in propensity score matching.
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Transapical NeoChord mitral valve repair
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