Objectives : The objective of this study is to evaluate survival and changes in left ventricular dimensions and function following mitral valve surgery in patients with mitral regurgi-tation due to degenerative disease and low left ventricular ejection frac­tion (EF <40%).
Methods : Mitral valve surgery was performed in 51 patients (43 men and 8 women, mean age 59±14 years). All patients had myxomatous mitral valve disease. Patients with CAD were excluded. Thirty-seven pa­tients (72%) had EF between 20-40% and 14 patients (28%) had EF <20%. Most patients (80%) were in NYHA
classes III and IV. All patients were on optimal medical therapy. Twenty-nine patients (57%) had mitral valve repair and 22 patients (43%) had mi­tral valve replacement with mainte­nance of the attachments between papillary muscles and mitral annulus. The meantSD duration of follow-up was 5.9±3.9 years and was complete.
Results : There was one operative death (1.9%) and 20 (39%) late deaths, 10 (19.5%) were cardiac re­lated. Five-year survival was 82±5%. &95% of survivors were in NYHA classes II and I. Five-year freedom from reoperation was 97±2%. Five-year freedom from valve-related mor­bidity or mortality was 95+3%.