OBJECTIVES: Double valve replacement has been advocated for @entity1 with combined aortic and @entity339 . This study investigated the alternative that, when feasible, mitral valve repair with @entity886 is superior. @entity1 AND METHODS: From 1975 to 1998, 813 @entity1 underwent @entity886 with either mitral valve replacement (n = 518) or mitral valve repair (n = 295). @entity339 was rheumatic in 71% and degenerative in 20%. Mitral valve replacement was more common in @entity1 with severe @entity4794 (P =.0009), @entity955 (P =.0006), and in @entity1 receiving a mechanical aortic prosthesis (P =.0002). These differences were used for propensity-matched multivariable comparisons. Follow-up extended reliably to 16 years, mean 6.9 +/- 5.9 years. RESULTS: Hospital mortality rate was 5.4% for mitral valve repair and 7.0% for replacement (P =.4). Survivals at 5, 10, and 15 years were 79%, 63%, and 46%, respectively, after mitral valve repair versus 72%, 52%, and 34%, respectively, after replacement (P =.01). Late survival was increased by mitral valve repair rather than replacement (P =.03) in all subsets of @entity1 , including those with severe @entity4794 . After repair of nonrheumatic mitral valves, 5-, 10-, and 15-year freedom from valve replacement was 91%, 88%, and 86%, respectively; in contrast, after repair of rheumatic valves, it was 97%, 89%, and 75% at these intervals. CONCLUSIONS: In @entity1 with @entity340 , @entity886 and mitral valve repair (1) are feasible in many, (2) improve late survival rates, and (3) are the preferred strategy when mitral valve repair is possible.

Mitral valve repair with XXXX is superior to double valve replacement.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity339 :: ('MESH:D008944', 'Disease') :: ['mitral valve disease', 'Mitral valve disease'] @entity886 :: ('MESH:C563178', 'Disease') :: ['aortic valve replacement'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation'] @entity4794 :: ('MESH:D008946', 'Disease') :: ['mitral valve stenosis', 'mitral stenosis'] @entity340 :: ('MESH:D006349', 'Disease') :: ['double valve disease']
@entity886 :: (MESH:C563178,Disease) :: ['aortic valve replacement']
