Abstract 3370: Long-Term Outcome of Asymptomatic Severe Degenerative Mitral Regurgitation
BACKGROUND: Early surgery for degenerative mitral regurgitation is recommended in guidelines in the basis of few studies. Natural history of this disease is uncertain. Conservative management may warranty a survival with good outcome at long-term.
OBJECTIVE: We assessed whether conservative management of asymptomatic severe degenerative mitral regurgitation have a good outcome at long-term.
Methods and results: all consecutive patients with severe degenerative mitral regurgitation who had at least one echocardiographic register performed in our institution during 2002–2005 were identified. We excluded all patients who only had been admitted to valve replacement. Ninety-seven patients had severe degenerative mitral regurgitation. Sixty-eight pts were asymptomatic (70%). Follow-up was 6±5 y (1–22 y). Baseline LV parameters were: EDD 56±6 mm, ESD 35±6 mm, EF 61±9%. During the follow-up 16 patients (23%) were operated on (symptoms 10 pts, 4 pts LV dysfunction and 2 pts atrial fibrillation or pulmonary hypertension). Perioperative mortality was 2 patients (1.2%) and other 2 patients died during the follow-up (1 because heart failure and other due to acute coronary syndrome). Survival free of surgery or death was 98±5% at 5 y, 75±11% at 10 y. Among surviving patients who were not operated on, 44 (91%) were in FC I and 4 (9%) in FC II at final follow-up. Final echocardiographic parameters in those patients showed: EDD 59±7 mm, ESD 33±6 mm and EF 63±9%.
Conclusion: Our data suggested that patients with severe degenerative mitral regurgitation have a survival free of symptoms at long-term on conservative management.