Abstract
ABSTRACT:
We followed 41 patients with severe chronic heart failure and secondary mitral valve insufficiency, caused by coronary heart disease, who underwent surgical mitral valve repair. In addition to physical examination at follow-up, we studied their quality of life (QoL).
MATERIAL AND METHODS
We included all patients who were operated between 1996 and 2004, and follow-up was mainly from Dec 2004 to Jan 2005. All survivors were invited to an echocardiographic examination and to fill in a QoL - assessment questionnaire (SF-36). In addition their NYHA functional class was assessed.
RESULTS
88% (36/41) were in NYHA functional-class III or IV at the time of surgery. Ninetyfive percent had additional coronary artery by-pass grafting. Mortality was 39 % (16 /41). The deaths only occurred in patients with preoperative NYHA class IV. Preoperative renal failure and atrial fibrillation were also risk factors for death. The follow-up time was 34-90 months after surgery (average 58 months). At follow-up the NYHA-class of the survivors and their physical functioning scores correlated significantly (R= 0.67, p<0.0001). QoL compared to the population was significantly worse for all categories, except for bodily pain (p=0,073).
DISCUSSION
All the deaths occurred within the first 3 years, and might have been predicted by NYHA class IV, atrial fibrillation and renal failure preoperatively. Although the LVEDD of the surviving patients did not change significantly, their NYHA class was 2.2 at follow-up, reflecting symptomatic improvement. These patients had an acceptable quality of life at follow-up.