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Early Surgery: A Better Option for People With Severe Mitral Valve Regurgitation

Update Date: Aug 14, 2013 03:39 PM EDT

Based from a new study, researchers are now recommending that people with severe mitral valve regurgitation should have early surgery even if there are no symptoms present. In this Mayo Clinic study headed by researchers from the United States and Europe, they concluded that early surgery was more effective than the watch and wait approach. The watch and wait approach is often used for a lot of conditions, such as pancreatic cancer. However, for healthy people with this heart issue, surgery can improve long-term survival rates and lower the risk of heart failure.

"The results of the current study showed that early surgery provided significant benefits over watchful waiting-and interestingly, were of a magnitude greater than we anticipated," said lead author Rakesh Suri, M.D., D.Phil., a cardiovascular surgeon at Mayo Clinic in Rochester. "This is perhaps counterintuitive. Patients assume they are more severely affected if they need surgery. Actually the opposite is true. Once a patient develops severe mitral valve leakage-even without symptoms-we now know that it is preferable to promptly repair the leakage rather than letting the heart deteriorate."

For this study, the research team looked at 1,021 patients who have mitral valve regurgitation but did not have any of the symptoms or the classical triggers. The data came from the Mitral Regurgitation International Database, which collected information from France, Italy, Belgium and the U.S. Mitral valve regurgitation occurs when the mitral valve in the heart does not close normally. This could then lead to blood getting pumped backwards instead of forward. Since the blood is not travelling like it should be, the oxygen-rich blood cannot reach the rest of the body as efficiently. This condition is very common and symptoms might not start to manifest until people age or never at all. If symptoms are present and left untreated, the worst case scenario would be heart failure that could result in death.

From the sample set, 446 of them had surgery to repair their mitral valves within three months post diagnosis while 575 of them used the watch and wait approach. The participants were monitored fro 10 years. They discovered that patients who underwent surgery had an 86 percent long-term survival rate while the patients who waited had a 69 percent long-term survival rate. On top of that, the patients with repaired mitral valves had a seven percent risk of heart failure. The patients who waited had a 23 percent risk of heart failure.  

The findings were published in the Journal of the American Medical Association

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