Prophylactic mitral reconstruction for mitral regurgitation.
BACKGROUND
Mitral regurgitation (MR) will produce myocardial dysfunction. The goal of this study was to review outcomes of mitral valve reconstruction in asymptomatic patients with severe MR.


METHODS
From 1992 to 2000, 93 asymptomatic patients with degenerative disease and severe MR underwent mitral valve reconstruction. Mean preoperative left ventricular internal diameter diastole was 56 +/- 8 mm and ejection fraction was 60% +/- 6%. Mean age was 47 +/- 10 years and mean follow-up 23 +/- 27 months. All patients underwent complex reconstruction.


RESULTS
There were no deaths and two late reoperations. One was for systolic anterior motion of the anterior leaflet of the mitral valve requiring valve replacement and one for hemolysis requiring re-repair. There was one perioperative transient ischemic attack and no late thromboembolic events. At follow-up all but 1 patient remains in NYHA class I and all had no MR except in 2 patients at 63 and 89 months.


CONCLUSIONS
Mitral valve reconstruction for "asymptomatic" MR can be performed with no mortality and low morbidity before development of left ventricular dysfunction. Early prophylactic repair is advocated in the presence of severe MR if valve reparability is assured.
Smolens
I A
IA
Department of Surgery, University of Michigan Hospitals, Ann Arbor 48109-0348, USA.
Pagani
F D
FD
Deeb
G M
GM
Prager
R L
RL
Sonnad
S S
SS
Bolling
S F
SF
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors