Between December 1993 and December 1994, fifty-eight percent of the mitral valve patients (33/57) had undergone mitral valve repair. Their mean age was 49 (SD-16)0 years (range 11-75) and they were consisted with 15 males and 18 females. The
causes
of
mitral disease in 33 patients were classified as follows: 19 cases (58%) were degenerative, 9 (27%) were rheumatic, 3 (9%) were congenital and 2 (6%) were infectious. Carpentier's functional classification was consisted with Class Ⅰ 4 cases
(12%),
Ⅱ
25 (76%) and Ⅲ 4 (12%). Surgical techniques included prosthetic annuloplasty in 32 cases (97%), leaflet resection in 16 (48%), chorda shortening in 13 (39%), chorda transfer in 9 (27%), new chorda formation in 7 (21%), commissurotomy in 7 (21%),
leaflet mobilization in 4 (12%), chorda resection in 3 (9%), papillary muscle splitting in 2 (6%), cleft repair in 2 (6%), leaflet patching in 1 (3%) and vegetation removal in 1 (3%). Average number of mitral anatomical lesions per patient was
3.3
and
vegetation removal in 1 (3%). Average number of mitral anatomical lesions per patient was 3.3 and We used average 3.0 procedures upon mitral valve apparatus per patient. Intraoperative transesophageal echocardiography was carried out in 27
patients
(82%) for providing an immediate and accurate assessment of the adequacy of the reconstruction before closure of the chest. Operative mortality was absent. The mean functional class (NYHA) was 2.87 preoperative and improved to 1.03
postoperatively.
Postoperative Doppler echocardiography showed much improvement from grade Ⅱ MR (5), grade Ⅲ (5), grade Ⅳ (21) to no MR (26), only trace MR(3), grade Ⅲ MR (2). Postoperative mean mitral valve area was 2.4*0.6 cm* (range 1.5-4.0).
We conclude that cautiously evaluated mitral valve reconstruction is stable and predictable operation with minimal postoperative left ventricular dysfunction.
(Korean J Thorac Cardiovasc Sung 1995;28:1107-12)
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