Mitral valve reconstruction: long-term results of 120 cases.
Between January 1977 and December 1992, 120 patients underwent mitral valve reconstruction for pure mitral valve regurgitation (n = 88), or associated with mitral stenosis (n = 32). The mean age was 57.6 years. Some 89 patients were in New York Heart Association (NYHA) class III and IV; 61% were in atrial fibrillation. Four mechanisms of mitral regurgitation were assessed: dilatation of the annulus (group I: n = 10); increased amplitude of valve motion (group II: n = 62); restriction of valve motion (group III: n = 23), and mixed lesions (group IV: n = 25). Mitral valve repair was carried out using techniques described by Carpentier. Ring annuloplasty was performed in all patients. There were two operative deaths, and six late deaths. Mean patient follow-up was 41 (range 2-142) months. The actuarial survival rate, excluding hospital deaths, was 91.7% at 5 years and 89.1% at 8 years. Actuarial freedom from reoperation at 8 years was 95(2)%. Freedom from all thromboembolic complications was 89.1% at 8 years. Most survivors had improved to NYHA class I or II and postoperative Doppler echocardiography revealed satisfactory mitral valve competence in 83 patients. Mitral valve reconstruction for mitral regurgitation using Carpentier techniques provides excellent long-term functional results and should be considered as the procedure of choice in patients referred for mitral regurgitation.
Soyer
R
R
Department of Cardiac Surgery, Hôpital Charles Nicolle, CHU Rouen, France.
Bouchart
F
F
Bessou
J P
JP
Tabley
A
A
Mouton-Schleifer
D
D
Redonnet
M
M
Arrignon
J
J
Letac
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome