Status of mitral valve surgery.
OBJECTIVE
To review the evolution of mitral valve repair and outline currently favored repair techniques.


RESULTS
Chordal replacement with polytetrafluoroethylene sutures is an accepted and reproducible technique for repair of the anterior leaflet. Most posterior leaflet problems can be addressed with either a quadrangular resection or a sliding repair.


CONCLUSIONS
Mitral valve surgery has gradually evolved over the period of the last 50 years. Initially, most surgeons replaced the mitral valve in patients with regurgitant disease. It is now known, however, that long-term outcome for patients undergoing repair is superior to that for patients undergoing replacement. Mitral valve repair avoids the complications associated with the artificial valve and anticoagulation. The ability to reproducibly repair the mitral valve requires a detailed knowledge of the disease process and the reparative techniques. This article describes the current approach to mitral valve surgery and the important concepts necessary to achieve a durable repair.
Walkes
Jon-Cecil M
JC
Methodist Hospital, Houston, Texas, USA.
Reardon
Michael J
MJ
D002404:Catheterization / Q000379:methods; D017548:Echocardiography, Transesophageal; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000601:surgery; D011300:Preoperative Care; D016896:Treatment Outcome