MITRAL VALVE REPLACEMENT - REVIEW OF 7 YEARS EXPERIENCE

The clinical experience with mitral valve replacement at the Presbyterian-St. Luke's Hospital in Chicago since August 1961 is reviewed. The over-all operative mortality was 20 per cent with an additional 11 per cent late deaths during a mean follow-up period of 20 months. In reviewing the factors influencing the results of surgery, a direct correlation was found between the operative mortality and the level of pulmonary vascular resistance, the preoperative functional classification of the patients and whether or not a previous mitral operation had been performed. Sixty-nine per cent of the patients are still alive; of these, 90 per cent have benefited greatly from the operation. Disabling late complications have been rare. It is concluded that this modality of treatment should be utilized only in patients whose progressive cardiac decompensation indicates poor prognosis without surgery. Likewise, patients in New York Heart Association functional classification III should not be permitted to progress into class IV before valve replacement is offered since cumulative mortality doubles when this occurs. © 1969.