[Reconstructive mitral valvuloplasty. Results apropos of 53 cases]

In the last three years, 53 patients have undergone a valvuloplasty according to the Carpentier's principles. The patients age ranged from 5 to 35 years, with a mean of 14.3 years. The aetiology was congenital in one case, RHD in 45 cases, and endomyocardial fibrosis (EMF) in 7. The pre-operative condition was severe with 25 patients in class III and 10 patients in class IV. There was a cardiomegaly with a mean CTR of 0.70 (extremes 0.50 and 0.85). The mitral lesions were pure mitral insufficiency in 49 cases, and mixed lesions with predominant insufficiency in 4 cases. There were also 6 aortic and 4 tricuspid significant insufficiencies. The patients have had a valvuloplasty with chordae shortening (n: 46) valvular resection (n: 3), chordae resection (n: 8), annuloplasty without ring (n: 38) or with ring (n: 2). There were associated procedures: endocardectomy (n: 7), aortic valvuloplasty (n: 3), aortic valve replacement (n: 3), tricuspid annuloplasty (n: 4). There were 3 post-operative deaths in children in class IV, with cardiomegaly (CTR 0,80), and systemic pulmonary hypertension. There were 3 mitral valve replacements (MVR) in the first month for failure of the plasty, 2 late MVR for endocarditis and rheumatic evolution. There were 3 mitral valve replacements (MVR) in the first month for failure of the plasty, 2 late MVR for endocarditis and rheumatic evolution. There were 2 late deaths (recurrent mitral insufficiency, serum hepatitis), Among 43 long-term follow-up of patients with a plasty (mean follow-up 18 months), the result has been very good 39 times. There were 4 patients with a significant residual mitral incompetence.(ABSTRACT TRUNCATED AT 250 WORDS)