Abstract Introduction: Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenerative mitral regurgitation (MR) and to identify predictive factors for outcomes. Methods: This is a retrospective cohort including patients undergoing mitral valve repair for degenerative MR from 2000 to 2018. The main techniques were Wooler annuloplasty and quadrangular resection. Kaplan-Meier curves and Cox regression models were used for statistical analysis. Results: One hundred fifty-eight patients were included (median age: 64.0 years). In-hospital mortality was 2.5%. Maximum follow-up was 19.6 years, with a median of 4.7 years (992 patient-years). Overall survival at 5, 10, and 15 years was 91.0% (95% confidence interval [CI]: 85.7-96.3), 87.6% (95% CI: 80.7-94.5), and 78.1% (95% CI: 65.9-90.3), respectively. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was an independent predictor of late death (hazard ratio [HR] 1.42; P=0.016). Freedom from mitral reoperation at 5, 10, and 15 years was 88.1% (95% CI: 82.0-94.2), 82.4% (95% CI: 74.6-90.2), and 75.7% (95% CI: 64.1-87.3), respectively. Left atrial diameter > 56 mm was associated with late reintervention in univariate analysis (HR 1.06; P=0.049). Conclusion: Degenerative MR can be successfully treated with repair techniques without annular support, thus avoiding the technical and logistical drawbacks of ring/band implantation while maintaining good long-term results. EuroSCORE II was a risk factor for late death, and larger left atrium was associated with late reoperation.

OBJETIVO: Avaliar o efeito prognóstico da esclerose valvular aórtica na mortalidade e morte de causa cardíaca de pacientes atendidos no Instituto de Cardiologia do Rio Grande do Sul nos anos de 1996 a 2000. MÉTODOS: Estudo de coorte histórico que utilizou informações contidas nos bancos de dados do laboratório de ecocardiografia do Hospital de Cardiologia e nos Registros de Óbitos da Secretária da Saúde do Rio Grande do Sul. O período de avaliação foi de 1996 a 2000. Os desfechos foram morte e morte de causa cardíaca. RESULTADOS: Foram analisados 8.585 casos, dos quais 2.154 (25%) eram portadores de esclerose valvular aórtica. O tempo de seguimento médio foi de 41±6 meses, e a ocorrência de morte e morte cardíaca foram respectivamente, de 299 (3,5%) e 95 (1,1%). O grupo de pacientes com esclerose valvular aórtica apresentou mais miocardiopatia segmentar, disfunção ventricular, aumento ventricular e hipertrofia ventricular, e não apresentou, entretanto, maior risco de morte ou morte de causa cardíaca quando feita análise de multivariança. CONCLUSÃO: A presença de esclerose valvular aórtica não aumentou o risco de morte e de morte de causa cardíaca na população estudada.

OBJECTIVE: To evaluate the prognostic effect of aortic valve sclerosis on all-cause and cardiovascular mortality of patients seen at the Cardiology Institute of the Brazilian state of Rio Grande do Sul from 1996 to 2000. METHODS: A historical cohort study using information from both the database of the Echocardiography Laboratory of the Cardiology Hospital and the Death Registry of Rio Grande do Sul Health Department. The evaluation was carried out from 1996 to 2000. Study endpoints were all-cause and cardiovascular mortality. RESULTS: A total of 8585 patients were analyzed, 2154 (25%) of whom had aortic valve sclerosis. Mean follow-up was 41±6 months, and all-cause and cardiovascular deaths were 299 (3.5%) and 95 (1.1%), respectively. The group of patients with aortic valve sclerosis had more segmental cardiomyopathy, ventricular dysfunction, ventricular enlargement, and ventricular hypertrophy; yet, they did not show higher risk for all-cause or cardiovascular mortality in the multivariate analysis. CONCLUSION: The presence of aortic valve sclerosis was not associated with increased risk for all-cause and cardiovascular mortality in the population studied.