RESULTS:
Valve repair was performed in 42% (n=164) of patients and replacement
in 58% (n=229). Patients who underwent replacement were older and had a
higher prevalence of unstable angina, New York Heart Association class
IV symptoms, preoperative cardiogenic shock, preoperative myocardial
infarction, peripheral vascular disease, renal failure, and urgent or
emergency surgery (all p < 0.05).
Unadjusted hospital mortality was higher in patients undergoing valve
replacement (13% versus 5%, p = 0.01). Valve repair was associated
with a lower prevalence of postoperative low cardiac output syndrome.
Multivariable analysis revealed that age, urgency of operation, and
preoperative left ventricular function were independent predictors of
hospital mortality. Importantly, mitral valve repair versus replacement
was not an independent predictor of hospital mortality.