[Surgical treatment of mitral valve insufficiency]

The paper reports on 127 operations on the open heart for mitral incompetence, including 112 prostheses and 15 annuloplasties on the support ring. After operation 28 (22.0%) patients died. Among the operated on patients with stage II-A circulatory insufficiency mortality was 9.3%, in those with stage II-B it was 28.5%. Mortality with mitral valve prosthesis was 24.1%, with annuloplasties 6.7%. The use of hypothermia and pharmaceutical agents for myocardium protection permitted the mortality decrease to 12.1%. The ten-year survival among patients subjected to prosthesis for mitral incompetence was 54.6%, the mortality in patients with stage II-A circulatory insufficiency was 75.4%, and in those with stage II-B it was 40%. The operations for mitral incompetence must be undertaken before the degenerative changes in the myocardium and other organs develop. In mitral competence prosthesis is indicated only in cases where the valve sparing operation is impossible.