Valvular & structural heart diseaseCohort study
Long-Term Outcomes of Early Surgery Versus Conventional Treatment for Asymptomatic Severe Mitral Regurgitation: A Propensity Analysis
- Prospective cohort study
- propensity score adjustment
- propensity-score matched
Authors' conclusion
Compared with conventional management, early surgery is associated with better long-term outcomes among asymptomatic patients with severe mitral regurgitation and preserved left ventricular function.
Study context
- Population
- Consecutive asymptomatic patients with severe degenerative mitral regurgitation and preserved LV function, 1996–2016
- Participants
- 1,063 patients · 358 matched pairs
- Exposure
- Early surgery vs conventional treatment
- Early surgeryn = 545
- Conventional treatmentn = 518reference
- Outcome
- Overall and cardiac mortality
- Follow-up
- Median 12 years (IQR, 8-17 years)
Main finding
As reported in the abstract
Early surgery
8 (1.5%)
CV death · All-cause death 74 (13.6%)
Conventional treatment
54 (10.4%)
CV death · All-cause death 116 (22.4%)
Early surgery vs Conventional treatmentHazard ratio (95% CI)P value
CV death
0.17(0.07–0.40)
P < 0.001all-cause death
0.72(0.52–0.99)
P = 0.046Observational data: associations, not effects.
Further findings
| Outcome | Early surgery | Conventional treatment | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Cardiac mortality, propensity score matched pairs · 20 years · rates at 20 years P=0.002 | 5.6% | 17.4% | 0.18 (0.08–0.43) | P < 0.001 | |
| Overall mortality, propensity score matched pairs · 20 years · rates at 20 years P=0.015 | 28.2% | 33.9% | 0.66 (0.47–0.93) | P = 0.018 | |
| 0.050.21520Hazard ratio (log scale) |
- Mitral valve repair success (early surgery)
- 97%
- Operative deaths (early surgery)
- 0 · events
- Cardiac mortality, propensity score matched pairs: matched cohort (358 pairs)
- Overall mortality, propensity score matched pairs: matched cohort (358 pairs)
Original publication
Long-Term Outcomes of Early Surgery Versus Conventional Treatment for Asymptomatic Severe Mitral Regurgitation: A Propensity Analysis. Circulation. Published 13 August 2025. doi:10.1161/circulationaha.125.074560
Summarised from the published abstract; every number is checked against it