Twenty-Year Outcome After Mitral Repair Versus Replacement for Severe Degenerative Mitral Regurgitation: Analysis of a Large, Prospective, Multicenter, International Registry
Authors' conclusion
Among patients with degenerative mitral regurgitation with a flail leaflet referred to mitral surgery, MV repair was associated with lower operative mortality, better long-term survival, and fewer valve-related complications compared with MV replacement.
Study context
- Population
- Patients with degenerative mitral regurgitation with a flail leaflet referred to mitral surgery (MIDA registry)
- Participants
- 1,709 vs 213
- Exposure
- Mitral valve (MV) repair vs MV replacement
- MV repairn = 1,709
- MV replacementn = 213reference
- Outcome
- Very long-term outcome (survival)
- Follow-up
- 20 years
Methodological details6 tertiary European and US centres, propensity-score matched, inverse probability-of-treatment weighting
- 6 tertiary European and US centres
- Propensity-score matched
- Inverse probability-of-treatment weighting
Main finding
As reported in the abstract
Twenty-year survival
Twenty-year survival · 20 years
Matched population
P < 0.001
- MV repair vs MV replacement: P < 0.001 — entire population
Observational data: associations, not effects.
Further findings
Operative mortality (death within 30 days or same hospitalization) · entire population
P < 0.001
Matched population
P < 0.001
Survival by age, sex or other stratification (subgroups)
- Similar superiority of MV repair in all subsets
- all P<0.001
Reoperations and valve-related complications
- MV repair associated with reduced incidence
Original publication
Twenty-Year Outcome After Mitral Repair Versus Replacement for Severe Degenerative Mitral Regurgitation: Analysis of a Large, Prospective, Multicenter, International Registry. Circulation. Published 29 November 2016. doi:10.
Summarised from the published abstract; every number is checked against it