[Adherence to valve repair surgery: from the mitral to the aortic valve]

Mitral valve repair for regurgitation has recently become more predictable based on its high reproducibility and excellent long-term durability. Since October 1992, mitral valve repair has been attempted in 123 patients with dominant regurgitation and achieved in 121 patients (98%). The hospital mortality was 1.7% and reoperation was carried out in five patients (4.1%). Follow-up study of mitral regurgitation by echocardiography showed that the regurgitation was trivial or none in 100 patients (88%), mild in 9 (8%) and moderate or over in 5 (4%). The indication of mitral valve repair is now being expanded to more complex lesions, ischemic papillary muscle rupture, active infective endocarditis and recurrent lesion. Furthermore, repair for insufficient aortic valve was begun in January 1994 and has been performed in 34 patients (87%) of 39 with aortic regurgitation. The hospital mortality was 2.9% and reoperation was needed in two patients (6%). The degree of aortic regurgitation after discharge was estimated as trivial or none in 23 patients (70%), mild in 7 (21%), and moderate in 1 (3%). The results of mitral valve repair support an aggressive approach toward mitral regurgitation with valve repair. Although aortic valve repair seems to be less satisfactory, a definite group of patients will benefit by preventing the need for a prosthetic valve.