Mitral Surgery for Asymptomatic Patients

[tobagotwo]

If you have mitral regurgitation (leakage, insufficiency) and your condition is being "managed" with drugs, you should read this...

From the RJWUH site:

New Study Highlights Importance of Heart Valve Repair

March 7, 2005
A new study suggesting that people with leaky heart valves with no symptoms are in greater danger than previously thought is highlighting the importance of valve repair surgery.

The study, published in the New England Journal of Medicine, showed that valve surgery gave normal life expectancy to patients with severe mitral regurgitation but no symptoms. Patients with severely leaky heart valves who were only treated with medication were more than five times more likely to die than those who underwent valve repair surgery, according to the Mayo Clinic study.

Here is the original article, but you must have a subscription to the NEJM to read it: http://content.nejm.org/cgi/content/extract/352/9/928

An associated article by Allen S. Brett, MD, clarified the numbers:

Researchers followed 456 patients (mean age, 63) with initially asymptomatic primary MR due to diseased valve leaflets (as opposed to MR secondary to dilated cardiomyopathy or ischemia); 80% had mitral valve prolapse. Effective regurgitant orifice (determined by echocardiography) was the best predictor of adverse outcomes. Even with medical management, patients with orifices of 40 mm2 and those with orifices of 20 mm2 to 39 mm2 had significantly reduced 5-year survival compared with expected U.S. survival rates (58% and 66% vs. 78%). Patients with orifices of <20 mm2 had normal survival rates.

This article can be found at: http://general-medicine.jwatch.org/cgi/content/full/2005/315/1

Best wishes,