The long-term results of surgical treatment in 97 cases of acquired valvular disease were compared with observations in 102 medically treated patients.
In the medical group, the 10 year survival was 48% in isolated mitral stenosis and 59% in mitral regurgitation with or without stenosis. The eight-year survival in aortic valve disease with or without mitral involvement was 70%. The leading cause of death was congestive heart failure, followed by cerebral embolism and sudden death.
The survival was significantly better in the surgical than in the medical group in the presence of obvious signs or histories of congestive heart failure. The prognosis was also more favorable in surgical group of mitral valve disease of NYHA functional classes II-IV. The occurrences of congestive heart failure and thromboembolism were less frequent in the surgical group.
Based on the above findings, we conclude that surgical intervention is indicated in valvular disease when signs or histories of congestive heart failure are obvious. Surgery is also the treatment of choice in mitral valve disease of NYHA functional classes II-IV.