[Valvuloplasty for congenital mitral valvular diseases]

Valvuloplasty is first applied as the surgical treatment for congenital mitral regurgitation (MR). Follow up study after the operation around the valvuloplasty was performed in the patients with congenital MR. In the patient under 12 years old, there were isolated MR in 3; MR associated with VSD in 14; MR and ASD in 3; MR with PDA in 10; and MR with ECD in 36. Operative methods were suturing of mitral cleft in 27; mitral annuloplasty in 17; mitral valve a, advancement in 7; cusp plasty in 4; no treatment for the MR in 14. Early death was noted in 6 cases (9.0% of mortality) and late death was noted in 3 cases (mortality rate of 9.0%). Conclusions were as follows: Surgical treatment was required in the patients with MR more severe than Sellers' Grade-II. Single suturing was recommended for the suturing of mitral cleft because shortening of the valve occurred in a few degree and the residual regurgitation reduced. Mitral valve advancement by elongation of the valvular apex was useful for the impediment of the regurgitation caused by incompetence of mitral coaptation. Mitral annuloplasty increased the effect for the impediment of the regurgitation. Ultrasonic cardiogram was useful for the follow up after the operation of the mitral valvuloplasty.