The life expectancy in a person whose mitral regurgitation (MR) was diagnosed and in a person whose mitral valve regurgitation was not diagnosed until complications develop drastically changes. Also, in people who were diagnosed with mitral valve regurgitation the timing and the type of treatment that is carried out also affect the life expectancy.
Life Expectancy With Mitral Valve Regurgitation
If mitral valve repair was done before the onset of mitral valve regurgitation symptoms and before the occurrence of complications especially left ventricular systolic dysfunction, the life expectancy is similar to a person from a general population. When heart failure has occurred (person in NYHA 3-4) before the mitral valve repair surgery then there is a significant reduction in the long-term survival regardless of the left ventricular function. Same way a person with impaired left ventricular function has even more less long-term survival rate.
Asymptomatic chronic severe degenerative mitral valve regurgitation has a mortality rate of 50-73% at 5 years, in patients whose left ventricular function is preserved it ranges from 27-45% and sudden death can occur in 1-8% of patients per year with a flail leaflet. Presence of functional MR cause 2-fold increased risk of all-cause mortality and hospitalization at 1-5 years.
The survival rates from mitral valve replacement is lower than of mitral valve repair. The mortality rate of mitral valve repair is about 1-2% and in mitral valve replacement its about 5-7% in patients younger than 50 years and 17% in patients older than 80 years. Other than that, bioprosthetic valves wear out easily than the mechanical valves and needs to be replace in about 10-12 years whereas mechanical valves last for about 25 years.
Data that is available on the long-term survival rates from mitral valve repair and cardiac surgery are form patients who underwent surgery 10-20 years ago. The surgical methods and approaches have improved since that time and still there is no way of evaluating the long-term life expectancy of the people who underwent the latest treatment methods.
The 30-day mortality rate after mitral valve surgery is about 2.7-25% for isolated mitral valve disease and in complicated surgeries with combined procedures the mortality rate is about 20.4%.
Factors Affecting The Life Expectancy
This study was conducted by Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Italy. The study recruited 814 outpatients with type 2 diabetes mellitus who were diagnosed with mitral valve regurgitation through an echocardiography and they were followed up for a mean period of 9 years. 120 patients out of the 814 died due to cardiovascular reasons and the severity of the mitral valve regurgitation had a significant impact on all of those cases. Mitral valve regurgitation patients have increased risk of cardiovascular mortality and all-cause mortality.
At 10 years follow-up the survival rate of patients without mitral valve regurgitation was 90%, in patients with mild mitral valve regurgitation it was 69% and in patients with moderate or severe the survival rate was 47%. The study also showed that the severity of mitral valve regurgitation and increase risk of cardiovascular mortality and all-cause mortality was affected minimally by:
- Age
- Sex
- Hypertension
- Dyslipidemia
- Duration of diabetes
- eGFR
- Ejection fraction
- Presence of mitral valve disease
- Presence of aortic-valve sclerosis
In 376 patients who had a normal mitral valve with a normal systolic function and mild mitral valve regurgitation had increased risk of all-cause mortality and cardiovascular mortality.
Conclusion
The life expectancy in a person whose mitral regurgitation (MR) was diagnosed and in a person whose mitral valve regurgitation was not diagnosed until complications develop drastically changes. Also, in people who were diagnosed with mitral valve regurgitation the timing and the type of treatment that is carried out also affect the life expectancy. If mitral valve repair was done before the onset of mitral valve regurgitation symptoms and before the occurrence of complications, the life expectancy is similar to a person from a general population. When heart failure has occurred (person in NYHA 3-4) before the repair surgery long-term survival rates are low. The mortality rate of mitral valve repair is about 1-2% and in mitral valve replacement its about 5-7%. The 30-day mortality rate after mitral valve surgery is about 2.7-25% for isolated mitral valve disease and in complicated surgeries with combined procedures the mortality rate is about 20.4%.
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