ABSTRACT
Mitral valve repair rather than replacement was performed in 133 of 183 patients (73%) with considerable mitral valve insufficiency requiring surgery. There were seven operative deaths (50%) and 16 late deaths in the 133 patients followed up from 1 to 15 years. Only four of the late deaths were possibly related to the underlying valvular heart disease. Repair is preferable to replacement with present-day mitral valve prostheses.
Subject(s)
Mitral Valve Insufficiency/surgery , Mitral Valve/surgery , Adolescent , Adult , Aged , Cardiac Surgical Procedures/mortality , Chordae Tendineae/surgery , Follow-Up Studies , Humans , Methods , Middle Aged , Mitral Valve Insufficiency/etiology , Papillary Muscles/surgery , Postoperative Complications/mortality , Time FactorsABSTRACT
This study represents an analysis of 13 cases of ruptured interventricular septum occurring as a complication of myocardial infarction. The cases considered appeared to divide themselves into two groups. One group survived the septal rupture for weeks or months and underwent surgery in the chronic stage. The patients in the other group were diagnosed and underwent surgery in the acute stage because of clinical indications of a rapidly deteriorating situation. There were four serious complications resulting from extensive cardiac catheterization and angiographic procedures. Those patients who were diagnosed using bedside balloon-directed catheterization techniques had no serious complications. The data indicate that: (1) the diagnostic approach should be executed quickly and by simple methods; (2) it is possible to operate successfully upon these patients in the acute phase of their disease; and (3) because of the unpredictable course and rapid deterioration, these alternatives should be strongly considered.
