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European Heart Journal 1991 12(Supplement B):5-9; doi:10.1093/eurheartj/12.suppl_B.5
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Natural history of severe mitral regurgitation

J. P. Delahaye, J. P. Gare, E. Viguier, F. Delahaye, G. De Gevigney and H. Milon

Hôpital Cardiologique, Faculté Alexis Carrel Lyon, France

Correspondence: J. P. Delahaye, Hôopital Cardidogique, BP Lyon Montchat, 69394 Lyon, Cédex 03. France.

The aim of this retrospective study was to review the outcome of 216paticnis (pts), investigated for severe mitral regurgitation (MR) between January 1980 and December 1987. .Dtfinition of ‘severe’ was mainly clinical: MR sufficiently advanced for the cardiologist to investigate whether surgery should be imminent. One hundred and sixty two pts (group 1) were operated on; 54 (group 2) did not undergo surgery. Baseline characteristia were similar in the two groups, exupt for aetiology (less dystrophic and more ischaemk MR in group 2), functional class (88.3% class III or IV in group 1 us 48·1% in group 2; P = 0·001), pulmonary pressures (lower in group 2) and left ventrkular ejection fraction (group 1: 0·66±0·13; group 2: 0·56±0·17; P=0·001).

Mean foUow-up after hospital admission or surgery was comparable in the two groups (group 1: 3·9±2·5 years; group 2: 3·5±2·7 years). Three pts (group 2) were lost to follow-up. Sixty-three pts died; 35 of the 162 operated on; 28 of the 54 non-operated on. Actuarial survival rate at 8 years was 74·0·4·3% in group 1 vs 33·2±9·2% in group 2 (P=0·001). These results confirm that the prognosis of severe MR is poor if it is not operated on, whereas the postoperative course of severe MR, when operated on in time, is good.

Key Words: Mitral regurgitation • cardiac surgery


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