[Mitral valves from the surgical-echocardiography viewpoint]

Prognosis for patients with mitral valve disease has significantly improved over the past 10 to 20 years. Progress in echocardiography has allowed for a more precise diagnosis and new interventional techniques and surgical approaches have made treatment results more predictable and more durable. Balloon-valvuloplasty has emerged as an effective procedure in certain patients with non-calcified mitral stenosis. Results after open surgical reconstruction of regurgitant valves due to degenerative disease, prolapsing leaflets and torn chordae are very good and allow for close to normal life expectancy in patients with still normal left ventricular function. Prognosis after endocarditis and ischemic mitral insufficiency, on the other hand, remains uncertain and still carries a high operative mortality and late complication rate. Today's mechanical, bileaflet prostheses of pyrolitic carbon show excellent hemodynamics and a low complication rate, but still require strict anticoagulation.