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[Repair in rheumatic mitral valve insufficiency]
C Fucci1, M Ferrari, G La Canna
1II Divisione di Cardiochirurgia, Spedali Civili e Università degli Studi Brescia.
Giornale Italiano Di Cardiologia
|June 1, 1997
Summary
Mitral valve repair in rheumatic mitral insufficiency shows good long-term results, with 94.1% survival at 7 years. Using a prosthetic ring significantly improves freedom from reoperation.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Rheumatic Heart Disease
Background:
- Etiology significantly impacts mitral valve repair outcomes.
- Rheumatic mitral insufficiency is a common cause of valve disease.
Purpose of the Study:
- To evaluate the long-term efficacy of mitral valve reconstruction in patients with pure rheumatic mitral insufficiency.
- To identify factors influencing the success of rheumatic mitral valve repair.
Main Methods:
- Retrospective analysis of 61 consecutive patients undergoing mitral valve repair for rheumatic mitral insufficiency.
- Assessment of long-term survival and reoperation-free rates using actuarial methods.
- Comparison of outcomes based on annuloplasty technique (prosthetic ring vs. other types).
Main Results:
- No hospital mortality observed.
- 7-year actuarial survival rate of 94.1%.
- 83.3% of patients were reoperation-free at 7 years.
- Significantly higher freedom from reoperation in patients receiving a prosthetic ring (96.7%) compared to other annuloplasty types (59.3%; p=0.001).
- No correlation found between valve failure and age at reoperation.
- Low rates of thromboembolism (2 cases) and infective endocarditis (1 case).
Conclusions:
- Mitral valve reconstruction in rheumatic mitral insufficiency offers satisfactory long-term clinical results.
- Routine use of a prosthetic ring and careful patient selection are crucial for favorable outcomes.
- Improved detection and management of rheumatic activity during surgery are recommended.