Chronical mitral valve disease is related with
significant mortality and morbidity.[
17,
18] Thus, one
of the primary goals of MVR or MVr is to reduce the
mortality and morbidity rates. Although both methods
have some superiority to each other, there are no strict
rules about the order of the method that needs to be
selected in a specific type of the disease. In this study,
we investigated the effects of both treatment on the
QoL of the patients using the SF-36 scale.
It is not always possible to prevent mitral valve
regurgitation after MVr. Soon or later, regurgitation
is expected to recur. In the presence of a significant
level of calcification or fibrosis, it is reasonable to
perform a MVR operation to decrease the need for
reoperation. In a recent meta-analysis, MVR and
repair were compared in terms of multiple factors
and it was found that MVr was related to an increased
reoperation risk in patients with progressive rheumatic
mitral valve disease.[19] It was also reported that there
was no significant difference between MVR and MVr in terms of the survival rates in patients with
ischemic mitral valve disease.[20-22] However, 30 days
of mortality reduced in patients who underwent
MVr. In another study, MVr was found to be related
to a longer survival, and valve replacement was a risk
factor in terms of long-term mortality.[23] Based on
our findings, we can conclude that the method to be
chosen for patients with mitral valve disease needs
a multi-factorial assessment including age, etiology,
comorbidities, additional cardiac pathologies, and
severity of the mitral valve disease. Previous studies also showed that MVr was related with a lower
incidence of in-hospital mortality, longer survival,
increased left ventricle functions, and a lower risk
of valve-related complications.[24-26] Accordingly,
MVr is more popular, particularly in patients in
whom the ventricular function should be preserved
carefully.[27,28] The primary goal of mitral valve
operation is to heal the disease, while protecting the
functional capacity. Of note, the main goal of all
treatment modalities should be to improve the QoL
of patients.
Furthermore, we found significantly improved
pain scores in group 2 (p<0.01), while no statistically
significant improvement was seen in group 1 (p>0.05).
This finding is also consistent with the finding in a
previous study.[29] In the aforementioned study, however,
Goldsmith and Patel[29] compared preoperative SF-36
results with third-month results. In another study,
prognosis was reported to be poor in patients with
an EF <50% and left ventricle dysfunction.[6] In
addition, Goldsmith and Patel[29] found no significant
improvement in the QoL of the patients with an EF
value lower than 50%. Our study included only three
patients with an EF value lower than 50%, and a
significant improvement was seen in the QoL of these
three patients.
The major limitations of the present study include
being a single-center study, performing all operations
by three different surgical teams, a small sample
size, and not having mechanical and biological valve
replacements in two different groups.
In conclusion, our study results show a significant
improvement in the quality of life following both
treatments. However, mitral valve repair seems to be
superior to mitral valve replacement in terms of pain
scores.
Declaration of conflicting interests
The authors declared no conflicts of interest with respect
to the authorship and/or publication of this article.
Funding
The authors received no financial support for the research
and/or authorship of this article.
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