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OBJECTIVES

We sought to assess the incidence and determinants of sudden death (SUD) in mitral regurgitation due to flail leaflet (MR-FL).

BACKGROUND

Sudden death is a catastrophic complication of MR-FL. Its incidence and predictability are undefined.

METHODS

The occurrence of SUD was analyzed in 348 patients (age 67 ± 12 years) with MR-FL diagnosed echocardiographically from 1980 through 1994.

RESULTS

During a mean follow-up of 48 ± 41 months, 99 deaths occurred under medical treatment. Sudden death occurred in 25 patients, three of whom were resuscitated. The sudden death rates at five and 10 years were 8.6 ± 2% and 18.8 ± 4%, respectively, and the linearized rate was 1.8% per year. By multivariate analysis, the independent baseline predictors of SUD were New York Heart Association (NYHA) functional class (p = 0.006), ejection fraction (p = 0.0001) and atrial fibrillation (p = 0.059). The …