From July 1983 to December 1993, total 112 consecutive mitral valve replacements in 107 patients were performed in patient with mitral valvular abnormalities. To estimate the risk factor related to operative death, all patient's perioperative
date
were
reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age were 37.3±13.1 years ranging from 13 to 72 years. Thirty-seven
patients
were male and fourty-eight patients were female. Mean follow-up durations were 51.1±33.8 months ranging from 6 months to 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from 3.02±0.73 to 1.78±0.55,
and
also
in cardiothoracic ratio, from 0.61±0.09 to 0.58±0.08 at 6 months follow-up after operation.
Operative complications were detected in 23 patients(27.1%) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases.
Early mortality was 10.6%(n=9) and the most common cause of death was a congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period
of
our
mitral surgery was high(5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985).
Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this
study
were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation.
Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.
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