A Clinical Study of Mitral Valve Repair for the Treatment of Mitral Valve Insufficiency

ABSTRACT

BACKGROUND AND OBJECTIVES: Mitral valve repair is the main procedure for the treatment of mitral valve insufficiency. The aims of this study were to review the applied techniques. and to evaluate postoperative residual mitral valve insufficiency, to compare preoperative and postoperative cardiac functions and dimensions, to compare the effects of rigid and flexible ring annuloplasty, and to assess overall freedom from valve failure-related reoperation. SUBJECTS AND METHODS: From March 1996 to September 1999, 34 patients underwent mitral valve repair for the treatment of mitral valve insufficiency at our department. This group comprised ten males and twenty four females, aged 8 to 65 years. The causes of mitral valve insufficiency were of degenerative origin in 12 patients, rheumatic in 10, congenital in 9, cardiomyopathic in 2, and ischemic in 1. The applied valve repair techniques included annuloplasty, quadrangular resection, leaflet slicing, cleft repair, chordae shortening, chordae transfer, secondary chordae resection, new chordae formation, papillary muscle splitting, commissuroplasty, and commissurotomy. RESULTS: There was no early or late mortality. We encountered 8 residual mitral valve insufficiencies (more than grade II), 2 of which worsened and eventually required correction by valve replacement. There were no statistical differences seen between the effects of rigid and flexible ring annuloplasty on left ventricular function either before or 1 year following annuloplasty. The cardiac dimensions decreased significantly. The actuarial freedom from valve failure-related reoperation was 93.01% at 43 months. CONCLUSION: Mitral valve repair with preserved valvular apparatus showed that the repaired valves functioned well and cardiac dimensions recovered satisfactorily. There were no statistical differences between the effects of rigid and flexible ring annuloplasty on cardiac functions and dimensions either before or 1 year following annuloplasty.