Reconstructive surgery of mitral valve incompetence: ten-year appraisal.

摘要: Between January, 1969, and 1978, 551 patients with mitral incompetence were treated by a system of reconstructive techniques. Mitral valve was classified into three types according to leaflet pliability; type I normal motion, 150 cases; II, prolapse, 213 III, restricted 188 cases. Associated tricuspid valvular disease present in 174 cases (31.5%) prosthetic ring annuloplasty. The operative mortality rate 4.2% (16/377) the group 14% (25/174) mitral-tricuspid group. Follow-up data are available 341 from 1 year 10 years (average 4 1/2 years). late 7% (24/341). Actuarial curves including hospital show an 82% survival at 9 79% Thirty-seven (11%) underwent reoperation mainly for residual (17) or recurrent (16) incompetence. Thromboembolism occurred 12 embolic 0.6% per patient-year, even though 48% not given anticoagulants. According New York Heart Association (N.Y.H.A.) classification, 76% (207/270) Class I, 19% (51/270) 4% (10/270) 0.7% IV (2/270). Results postoperative catheterization angiocardiography 52 patients. Comparison between various groups shows that best results obtained II incompetence, followed III This experience demonstrates predictable stable long-term have been achieved techniques reconstruction low incidence thromboembolism. Reproducibility is limiting factor which can be overcome adequate training progressive experience. Patient selection based on rather than age, physical condition, cause disease.