Agneta Geldenhuys, Jithan J. Koshy, Paul A. Human, Juliana F. Mtwale, Johan G. Brink, Peter Zilla Christiaan Barnard Division of Cardiothoracic Surgery, Groote Schuur Hospital, University of Cape Town, South Africa |
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countries rheumatic heart disease is the predominant indication for cardiac surgery. As the disease tends to progress, reoperation rates for mitral valve repairs are high. Against this background, the predictors of failure were assessed and the overall performance of repairs compared with replacements in a 10-year cohort of rheumatic single mitral valve procedures. |
and ranged from 0.6 to 132 months (mean 53.3 ± 36.5 months). Actuarial freedom from valve-related mortality was 96 ± 3% and 92 ± 4% at five years, and 96 ± 3% and 80 ± 11% at 10 years for repairs and replacements, respectively (p = NS). Actuarial freedom from all valve-related events (deaths, reoperations and morbidity) was 80 ± 6% and 86 ± 5% at five years, and 70 ± 8% and 69 ± 11% at 10 years (p = NS). Actuarial freedom from all valve-related events was 57 ± 11% and 96 ± 3% at five years (p = 0.0008), and 42 ± 12% and 96 ± 3% at 10 years (p <0.001) for those mitral valve repairs with and without commissural fusion, respectively (p = 0.0002 overall). |
Rheumatic Mitral Repair Versus Replacement in a Threshold Country: The Impact of Commissural Fusion |
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