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

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 > or = 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 > or = 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 > or = 45 mm were unlikely to demonstrate a significant improvement in QOL at 3 months follow-up.