title: [Reconstructive surgery of pure mitral insufficiency. Operative results and follow-up in 128 patients].
abstract: Short and long-term results of valve repair for pure mitral insufficiency are reported in 128 consecutive patients with a mean age of 49 years (range 4-75). The etiology of the mitral valve dysfunction was degenerative in 54% of the cases, rheumatic in 30%, ischemic in 9.5%, endocarditic in 6.5%. Preoperatively, 91% of the patients were in NYHA class II or III. The anatomic lesions and the mechanism of mitral regurgitation were identified preoperatively by transthoracic and/or transesophageal echocardiography. Cardiac catheterization was performed only in patients with multiple valvular dysfunction and/or with evidence of concomitant coronary artery disease. Mitral repair was performed according to the techniques proposed by Carpentier. Only one patient died in the hospital (operative mortality: 0.8%). By actuarial methods, 96% of the patients were alive 4 years postoperatively, and 84% were reoperation free. Freedom from reoperation was significantly higher in patients who received a prosthetic ring than in those who had other types of anuloplasty (96% vs 67%; p < 0.05). During the follow-up period no patient had thromboembolic episodes. Ninety-seven per cent of the 112 patients who survived the operation and were not reoperated were in NYHA class I or II. These results confirm the validity of reconstructive surgery in pure mitral insufficiency. The use of a prosthetic ring gives stability to the repair and improves long-term results.
authors.affiliation: Divisione di Cardiochirurgia, Spedali Civili e Università Degli Studi di Brescia.
authors.forename: C
authors.initials: C
authors.lastname: Fucci
authors.forename: A
authors.initials: A
authors.lastname: Pardini
authors.forename: M
authors.initials: M
authors.lastname: Zogno
authors.forename: L
authors.initials: L
authors.lastname: Sandrelli
authors.forename: G
authors.initials: G
authors.lastname: La Canna
authors.forename: M
authors.initials: M
authors.lastname: Gargano
authors.forename: O
authors.initials: O
authors.lastname: Alfieri
authors.forename: O
authors.initials: O
authors.lastname: Visioli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000601:surgery; D012086:Reoperation
vernacular_title: Chirurgia ricostruttiva nell'insufficienza mitralica pura. Risultati operatori e follow-up in 128 pazienti.