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[Direct vision mitral valve reconstruction: a long-term follow-up of 46 cases]
1Department of Cardiovascular Surgery, Affiliated Hospital of Shandong Medical University, Jinan 250012.
Objective:
To improve the long-term results of direct vision mitral valve reconstruction.
Method:
From July 1983 through July 1995, 46 patients with mitral valve disease were treated by a direct vision reconstructive techniques. Rheumatic valve stenosis and incompetence were noted in 39 (patients), nonrheumatic insufficiencies in 5, and congenital disease in 2. According to leaflet pliability, type I normal leaflet motion was notedin 17 patients, type II leaflet prolapse in 3 and type III restricted leaflet motion in 29. Cardiac function (NYHA classification) showed class II in 2, class in 25 III, and class IV in 19. Valvuloplasty and annuloplasty were performed with various techniques according to the pathanatomical changes of the valve. Prosthetic obturators self made were employed in 29 patients.
Result:
The operative mortality rate was 6% (3/46). In the mitral valve replacement group it was 10% (27/265). Two to 10 years (mean 65 months) follow-up showed grade I cardiac function in 6 patients, grade II in 17, grade III in 8, and grade IV in 3.
Conclusion:
Good long-term results can be achieved by valve reconstruction with lower mortality and incidence of thromboembolism than.