A new approach to mitral valve repair for rheumatic disease: preliminary study.

摘要: Background and aim of the study: The initial application repair to rheumatic mitral disease was fraught with unacceptable recurrence rates. For this reason, valves primarily have been replaced in recent years. Early late outcomes replacement, however, continued be suboptimal, prompting a re-examination repair. Methods: All eight patients encountered by authors valve over past three years were considered for One patient had pure stenosis, regurgitation, four advanced forms mixed stenosis regurgitation. Because posterior leaflet retraction prominent almost uniform feature disease, glutaraldehyde-fixed autologous pericardial gussets placed all cases. In five commissural calcium debrided, thickened chords anterior resected, extended commissurotomies performed, an ‘hinge’ mechanism restored. then reattached base papillary muscles using Gore-Tex artificial chords, full ring annuloplasties. Results: Postoperatively, negligible gradients no residual leak. first (with regurgitation) restudied transesophageal echocardiography after years, excellent function. There intermediate-term recurrences, complications or mortalities. Operative videos echocardiograms from these are available at JScottRankinMD.com. Conclusion: A combination gusset, chordal resection/GoreTex commissurotomy annuloplasty allows range pathologies. results appear satisfactory. Continued aggressive type seems indicated.