[Reconstructive operations in mitral insufficiency under whole-body hypothermia (27-25 degrees C) without perfusion]

The article discusses the results of reconstructive valve-preserving operations in mitral insufficiency performed under conditions of hypothermic (27-25 degrees C) protection without perfusion in 114 patients. Depending on the valve morphological changes multicomponent intervention was under taken contemplating the performance of commissurotomy, chorda fenestration, resection and sewing of the cusps, removal of fibrous deposits from the cusps, resection of peripheral and intermediate chordae. The discrepancy between the cusp area and the perimeter of the fibrous ring was corrected in 99 patients by annuloplasty with sutures. The hospital mortality was 6.1%. Six-year postoperative survival was recorded in 91% of cases; no thromboembolic complications encountered in 97.4% of patients. The condition improved in most patients and they moved to NYHA Functional Class I-II. Unfavourable results were due to a severe initial clinical and functional condition and to the operations conducted in the active stage of septic endocarditis.