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Eur J Cardiothorac Surg 2001;20:949-955
© 2001 Elsevier Science NL

A prospective study of changes in the quality of life of patients following mitral valve repair and replacement

^a Department of Cardiothoracic Surgery, Walsgrave Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UK
^b University Department of Medicine, City Hospital, Dudley Road, Birmingham, UK

Received 17 October 2000; received in revised form 9 July 2001; accepted 8 August 2001.

Corresponding author. Tel.: +44-2476-602020; fax: +44-2476-535105
e-mail: ira{at}iragoldsmith.freeserve.co.uk

Objective: The primary aim of medical care and surgery for mitral valve disease is to improve the overall functional capacity and health of patients. Aim: To assess whether there was an actual improvement in quality of life (QOL) of patients 3 months following primary mitral valve repair (MRr) or mitral valve replacement (MVR). Methods: Prospective study of 61 consecutive patients (34 males, mean age 64±12) who underwent primary, isolated mitral valve repair (MRr, n=40) or mitral valve replacement (MVR, n=21) from April 1997 to October 1998. QOL parameters using the validated short form 36 (SF-36) questionnaire were determined before and at 3 months after surgery and analysed using the Wilcoxon matched pairs rank test. Results: Mean QOL scores (scale 0–100) for all patients following mitral valve surgery showed clinical and statistically significant improvement in seven of eight QOL parameters, namely (i) physical function (post, 60±31 vs. pre, 44±29; P=0.0001); (ii) role limitation due to physical function (50±42 vs. 23±36; P=0.0002); (iii) social function (76±31 vs. 59±36; P=0.0006); (iv) role limitation due to emotional problems (65±42 vs. 44±45; P=0.003); (v) energy (57±24 vs. 40±24; P<0.0001); (vi) mental health (73±20 vs. 66±21; P=0.007); and (vii) general health perception (68±19 v 56±22; P=0.0001); but not pain (73±29 v 71±30; P=0.4). Following MRr there was significant improvement in seven of eight QOL parameters and following MVR there was significant improvement in three of eight QOL parameters. Whilst patients with ejection fraction 50% showed significant improvement in seven of eight QOL parameters, there was no significant improvement in any QOL parameters in patients with impaired left ventricular (LV) function. Similarly, patients with mitral regurgitation with end-systolic dimensions of 45 mm showed no significant improvement in any QOL parameters at 3 months follow-up. Conclusions: Our study suggests that following mitral valve surgery there was significant improvement in the QOL of patients especially in those patients requiring mitral valve repair. However, patients with impaired LV function and those with MR with end-systolic dimensions 45 mm were unlikely to demonstrate a significant improvement in QOL at 3 months follow-up.

Key Words: Mitral valve • Repair • Replacement • Quality of life

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