Research article summary (published 30 Dec 2004):

Mitral valve prolapse: diagnosis, treatment and natural course.

Full Abstract

This article analyzes data obtained from the medical records of the patients with primary mitral valve prolapse. The study population was the patients admitted to Kaunas University of Medicine Heart Center (KUMHC) between 1999 and 2003. The objective of our study was to analyze the natural course of mitral valve prolapse, complications and their frequency, treatment strategy in KUMHC, as well as to review the results of surgical treatment. We gathered data from the medical records of 160 patients and analyzed their age, medical history, complications, comorbidities, functional status and echocardiographic parameters. Patients who underwent mitral valve surgery were followed 7.9+/-8.4 months after procedure. On average, 32+/-14 patients with primary mitral valve prolapse were treated at KUMHC annually. Their mean age was 48.4+/-16.5 years, 44.4% of them were male. The most frequent complications of mitral valve prolapse were > or =II degrees mitral regurgitation (78.4%), various cardiac arrhythmias (68.1%) and heart failure of > or =II NYHA class (79%). Surgical treatment was recommended for 64 (40%) KUMHC patients with primary mitral valve prolapse. Surgical treatment was applied in 44 (28.1%) of study patients. The patients, who were recommended surgical treatment, were older (mean age 53.2+/-11.9 years, p<0.05) and predominantly male (62.5%, p<0.05) as compared to medically managed patients. The heart failure (62.5% had NYHA class III or IV), severe mitral regurgitation (95.3% had mitral regurgitation of > or =III degrees ) and worse left ventricle function (15% had ejection fraction of <50%) were more frequent in this group as compared to medically managed patients (all p<0.05). During the last five years the number of hospitalized patients with primary mitral valve prolapse increased 3.2 times, the number of mitral valve surgical procedures among these patients increased 2.8 times, and the number of mitral valve repair increased 15.8 times. 56.8% of patients had uncomplicated postoperative course. The most frequent postoperative complication was new arrhythmias and/or conduction disturbances. 1 patient died in early postoperative period. There was significant decrease in left ventricle and left atrium size and the severity of mitral regurgitation 2 to 6 months after mitral valve surgery. These positive changes remained during all study period. Taking in the consideration the large number of mitral valve repair procedures and good outcomes, the low postoperative mortality of the surgical mitral valve prolapse treatment in KUMHC, we can strongly recommend surgical treatment for the patients with severe mitral regurgitation secondary to mitral valve prolapse.

Author information

Author/s: Jonkaitiene, Regina (R); Benetis, Rimantas (R); Ablonskyte-Dudoniene, Ruta (R); Jurkevicius, Renaldas (R);

Affiliation: Clinic of Cardiology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Medicina (Kaunas, Lithuania) (Medicina (Kaunas)), published in Lithuania. (Language: eng)

Reference: 2005-; vol 41 (issue 4) : pp 325-34

Dates: Created 2005/05/02; Completed 2006/02/21; Revised 2006/11/15;

PMID: 15864006, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Age Factors Data Interpretation, Statistical Echocardiography Female Follow-Up Studies Hospitalization Humans Male

Male Middle Aged Mitral Valve Insufficiency - etiology; surgery Mitral Valve Prolapse - complications; diagnosis; physiopathology; surgery; ultrasonography Postoperative Complications Stroke Volume Time Factors Treatment Outcome Ventricular Function, Left - physiology

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