A new study has found that outcomes following mitral valve surgery have significantly improved over the years among patients with mitral regurgitation.

Researchers at Yale School of Medicine (Yale, New Haven, CT, USA) conducted a study that analyzed the 30-day and one-year mortality rate in 157,032 US Medicare fee-for-service (FFS) patients 65 years or older, who underwent mitral valve surgery between 1999 and 2008. They then denoted hospitalization rates per 100,000 beneficiary years--ascertained through corresponding inpatient and vital status files--for isolated mitral valve surgery, 30-day readmission, 30-day mortality, and one-year mortality outcomes, adjusting for age, sex, race, and comorbidities.

The results showed that during the study period, the overall rate of mitral valve surgery per 100K beneficiary-years declined from 56 to 51, and the proportion of patients undergoing mitral valve repair (versus replacement) increased from 24.7% to 46.9%. For isolated mitral valve surgery, there were significant declines in risk-adjusted 30-day mortality (8.1% to 4.2%) and one-year mortality (15.3% to 9.2%), and a slight decline in risk-adjusted 30-day readmission (23% compared to 21%). Overall, mortality rates decreased in all age, sex, and race subgroups, and among patients undergoing mitral valve repair or replacement, but remained higher among patients aged 85 years, women, and nonwhites. The study was published online before print on May 10, 2012, in Circulation: Cardiovascular Quality and Outcomes.

“The marked reduction in mortality after mitral valve surgery over time is an encouraging trend for cardiac surgery. Several factors may be responsible, including improved surgical techniques, and lower rates of post-operative complications,” said lead author John Dodson, MD, a postdoctoral fellow in cardiology and geriatrics at Yale. “There remain differences in the rate of mitral valve surgery performed, and mortality outcomes, among sex and race subgroups that deserve further investigation.”

Mitral regurgitation, the most common form of valvular heart disease, is a disorder of the heart in which the mitral valve does not close properly, causing blood expelled from the left ventricle through the mitral valve and into the left atrium (when the left ventricle contracts) to return back into the left atrium through the leaky valve.

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