Mitral valvuloplasty: a learning curve.
Failure to appreciate the importance of each of the functional components of the mitral valve has resulted in general disenchantment with the results of mitral valve annuloplasty. Consequently, the technique of mitral valvuloplasty evolved. From January 1981 through March 1982, 100 patients underwent mitral valvuloplasty. The following basic techniques were used: commissurotomy (55 patients), chordal resection (95 patients), shortening (52 patients) and fenestration (16 patients), resection of leaflet tissue (16 patients), and Carpentier-Edwards ring insertion (69 patients). Two consecutive groups of patients were compared. In group 1 (the first 30 patients) there were four early and two late deaths; in group 2 (the remaining 70 patients) there were no early and two late deaths. Three patients in each group required a subsequent valve replacement (p less than .01). Hence, the linear valve failure rate was 12.2% and 4.8% a patient year for groups 1 and 2, respectively. Seventy-one percent of the survivors in group 1 and 84% of those in group 2 had no or only mild residual mitral valve dysfunction. Poor initial results should not discourage surgeons because mitral valvuloplasty has a striking learning curve.
D000293:Adolescent; D000328:Adult; D002315:Cardiopulmonary Bypass; D002648:Child; D002815:Chordae Tendineae / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000033:anatomy & histology / Q000601:surgery*; D011183:Postoperative Complications