Mitral stenosis surgery outcomes and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]

Overview

The results of mitral valve stenosis surgery are excellent in centers that regularly perform this surgery.

Outcomes and Prognosis

Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.

  • Results of the commissurotomy should be assessed with hemodynamics and echocardiography.
  • If second inflation is needed mitral regurgitation should be assessed.
  • In general increasing valve area to greater than 1 cm2/m2 is an acceptable result.
  • Usually the valve area doubles and the pulmonary pressures degrease immediately.
  • 5 year survival is in the 90% range.

Mechanical Versus Biological Valves

  • Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
  • Biological valves tend to fail over time,[1][2] but they have a lower risk of blood clots.

References

  1. Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S (1993). "A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease". N Engl J Med. 328 (18): 1289–96. doi:10.1056/NEJM199305063281801. PMID 8469251.
  2. Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH (2000). "Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial". J Am Coll Cardiol. 36 (4): 1152–8. PMID 11028464.

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