Abstract 3447: Comparative Long-Term Survival of Dialysis Patients in the US after Mitral Valve Replacement and Mitral Annuloplasty
There are no published data comparing the long-term outcome of dialysis pts after mitral valve replacement (MVR) surgery and mitral annuloplasty (MA). We searched the records of 1,698,706 pts in the United States Renal Data System database and identified 4413 dialysis pts hospitalized from 1991–2004 for MVR or MA only (other valve sites excluded). Long-term survival was estimated by Kaplan-Meier method and independent predictors of death were examined in a comorbidity-adjusted Cox model.
RESULTS: The study cohort was 55% female, 58% white, 37% black, 36% DM as primary cause of ESRD, and 26% age 65+. MVR occurred in 3122 pts (71%) and MA in 1291pts (29%). Concomitant CAB occurred in 33.2% of MVR and 49.7% of MA. In-hospital death was 25.0% for MVR and 15.9% for MA. The table⇓ shows survival and predictors of death (age 20 – 44, other cause ESRD, no comorbidity, no CAB, MVR is reference) with risk ratio (RR).
Conclusion: Mitral valve surgery is associated with high short and long-term mortality in dialysis pts. The survival of dialysis pts undergoing mitral valve surgery is better after mitral annuloplasty compared to mitral valve replacement.