[Mitral valve repair for mitral regurgitation]. / Cirugía de reparación valvular en la regurgitación mitral.

We analyzed the results of mitral valve repair in 81 consecutive patients with severe mitral regurgitation. Of these patients, 66.6% had myxomatous degeneration, 11% ischemic disease, 8% chordal rupture, 5% congenital disease, and 3.7% endocarditis. Repair could not be achieved in five patients, and valve replacement was necessary. Six died during surgery (mortality 7%). During follow-up (mean 30 [8] months), there was one death due to refractory ischemic heart failure and mitral regurgitation (>or= 2/4) was observed in 11 patients. A good result (i.e., survival without a prosthesis, major complications, or mitral regurgitation >1/4) was obtained in 78% of patients with myxomatous degeneration versus 48% of those with other etiologies (P=.023). A good result was obtained more frequently in cases of isolated posterior cusp degeneration than in those involving degeneration of both cusps (85% vs 70%; P=.03).

Cirugía de reparación valvular en la regurgitación mitral / Mitral valve repair for mitral regurgitation

Analizamos los resultados de la reparación valvular mitral en 81 pacientes consecutivos con insuficiencia severa de la válvula. El 66,6% de los pacientes tenía degeneración mixoide; el 11%, etiología isquémica; el 8%, rotura de cuerdas; el 5%, congénita y el 3,7%, endocarditis. En 5 casos fue preciso sustituir la válvula al no conseguirse una reparación adecuada. La mortalidad operatoria fue de 6 pacientes (7%). En el seguimiento (media, 30 +/- 8 meses) hubo un fallecimiento por insuficiencia cardiaca isquémica refractaria y 11 pacientes quedaron con insuficiencia mitral >= 2/4. Se obtuvo buen resultado (supervivencia sin prótesis, regurgitación mitral > 1/4 o complicación mayor) en el 78% de los pacientes con afección mixoide frente al 48% de aquellos cuya enfermedad no era mixoide (p = 0,023). La tasa de buen resultado fue superior en la degeneración aislada del velo posterior que en la afección de ambos velos (85% frente a 70%; p = 0,003)

We analyzed the results of mitral valve repair in 81 consecutive patients with severe mitral regurgitation. Of these patients, 66.6% had myxomatous degeneration, 11% ischemic disease, 8% chordal rupture, 5% congenital disease, and 3.7% endocarditis. Repair could not be achieved in five patients, and valve replacement was necessary. Six died during surgery (mortality 7%). During follow-up (mean 30 [8] months), there was one death due to refractory ischemic heart failure and mitral regurgitation (>= 2/4) was observed in 11 patients. A good result (i.e., survival without a prosthesis, major complications, or mitral regurgitation >1/4) was obtained in 78% of patients with myxomatous degeneration versus 48% of those with other etiologies (P=.023). A good result was obtained more frequently in cases of isolated posterior cusp degeneration than in those involving degeneration of both cusps (85% vs 70%; P=.03)