Abstract
We sought to examine the comparative improvement in health status and clinical outcomes in patients undergoing primary mitral valve repair versus replacement with mitral valve disease (mitral stenosis or mitral regurgitation). We prospectively followed 44 patients with mitral valve regurgitation and stenosis who underwent primary mitral valve repair (n =15) and replacement (n =29) between January 2013 and March 2013. Health status was evaluated at baseline and 1, 3, and 6 months after surgery with the validated short-form 36, Echo parameters, anticoagulation management and from the sf-36, utility scores and Quality adjusted life years was calculated Quality of life scores were significantly improved after both procedures, with better improvement achieved by mitral valve repair (P < .05). For both treatment groups, scores for most of the short-form 36 domains were depressed at 1 month; however, after 3 and 6-month lags, dramatic improvements were achieved in most of the domains. For patients, who underwent repair showed significant improvement in 3 and 6_month particularly physical functioning, mental health. Clinical parameters like Ejection Fraction showed improvement in both groups with minimal difference. The Adverse drug reactions observed in replacement due to life time anticoagulation therapy are found to decrease quality of life scores (average=2.3). Utility, which is obtained from quality of life scores were also showed to be better in patients who underwent mitral valve repair (0.82) and mitral valve replacement (0.69). Our study suggests that after mitral valve surgery, there is significant improvement in health status (quality of life) and number of quality adjusted life years (QALY) gained, especially in patients undergone mitral valve repair, when compared to patients undergone mitral valve replacement.
