125 consecutive URMA for CIMR were dichotomized according to postoperative mean trans-mitral gradient (螖p) into Group A (61 patients, > 5 mm Hg) and Group B (64 patients, 鈮?#xA0;5 mm Hg). Echocardiographic, clinical and functional outcomes were prospectively recorded and compared.
There were no hospital deaths. Intensive-care and hospital length of stay were comparable in the 2 groups (p = N.S.). Twenty-three months of actuarial survival was 73.2 卤 8.0%, without inter-group differences (log-rank p = 0.627), actuarial freedom from congestive heart failure was 71.4 卤 5.6%, freedom from hospitalization was 59.8 卤 7.7%, without inter-group differences (p = 0.497 and 0.393 respectively), and actuarial freedom from recurrent CIMR was 62.7 卤 10.4%, without group-difference (p = 0.259), respectively. Both groups showed progressive improvement of NYHA (Time p = 0.0001), with reduced diuretics (p = 0.0001), and without inter-group differences (Group 鈦?#xA0;Time p = 0.894 and 0.397 respectively). Both groups showed a constant improvement of left ventricular end-systolic diameters, ejection fraction, CIMR-grade, tricuspid insufficiency grading, indexed left ventricular mass, systolic pulmonary arterial pressure, and tricuspid annular plane systolic excursion (Time p = 0.0001 for all), without intergroup differences (p = N.S. for all). However, left ventricular end-diastolic diameters were better remodeled in Group A (Group 鈦?#xA0;Time p = 0.037), together with a higher mean trans-mitral 螖p and a lower coaptation depth (Group 鈦?#xA0;Time p = 0.0001 and 0.05 respectively). Left atrial diameter was ameliorated in Group B, but remained unchanged in Group A (p = 0.168).
URMA cures CIMR. The induction of mild mitral stenosis did not affect clinical, functional and echocardiographic outcomes.