Korean J Thorac Cardiovasc Surg.
2000 Jan;33(1):32-37.
Early Results of Mitral Valve Reconstruction in Mitral Regurgitation
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University.
- 2Department of Thoracic and Cardiovascular Surgery, college of Medicine, Ewha Woman's University.
Abstract
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BACKGROUND: Reconstruction surgery of mitral valve regurgitation is now considered as an
effective operative technique and has shown good long-term results. Although reconstructive
surgery of mitral valve has been performed since 1970s, we have started only in early 1990s
in full scale because of small number of the mitral regurgitation compared to mitral stenosis
and lack of knowledge from the viewpoint of patients and physicians.
MATERIAL AND METHOD: From January 1992 to December 1996, 100 patients underwent repair of the
mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National
University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age
was 39.9+/-14.4 years. The causes of the mitral regurgitation were rheumatic in 61,
degenerative in 28 and others in 11. According to the Carpentier's pathological classification
of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were
type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent
aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation.
RESULT: There were no operative death but 3 major operative complications: 2patients were
postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and
1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was
sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred
mitral regurgitation. There were no statistically significant risk factors for reoperation.
The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in
NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related
complications.
CONCLUSIONS
We concluded that mitral valve repair could be performed successfully in most
cases of mitral regurgitation even in the rheumatic and combined lesions with very low
operative mortality and morbidity. The early results are very promising.