Mitral valve reconstruction: intermediate term results in rheumatic mitral regurgitation

From January 1988 through December 1992, 281 patients underwent reconstruction of the mitral valve for mitral regurgitation (MR) with or without mitral stenosis (MS). Two hundred and fifteen patients (76.2%) were between 11 and 30 years of age. The cause of mitral regurgitation was rheumatic in 248 patients (88.3%). Combined lesion (MR + MS) was present in 204 (72.6%). The technique included a modification of the posterior collar annuloplasty described by Cooley et al. Operative mortality was 3.9% (11 patients). There were four late deaths. The 270 operative survivors were followed up by physical examination, echocardiography or by a questionnaire mailed to them after March 1993. Follow up data was available in all but 14 patients (95%). The actuarial survival at 66 months was 95.2% and event free survival was 80%. We conclude that mitral valve repair in a mainly rheumatic patient population is feasible, the probability of reoperation is low and the symptomatic relief is gratifying.