Clinical Results of Mitral Valve Repair

승모판막질환의 판막재건술36례 성적

From January 1962 to March 1987, 97 patients underwent operation for mitral valve disease. Of these patients, 61 [62.9%] required mitral valve replacement. Thirty-six patients [37.1%] had mitral valve repair. The mean age was 26.9*11.6 years [range 5 months to 48 years]. There were 32 [88.9%] cases of rheumatic valve disease, 4 [11.1%] cases of congenital mitral valve disease. Valve dysfunction was classified into three types: type I [normal leaflet motion], 6 patients; type II [prolapsed leaflet], 1 patient; type III [restricted leaflet motion], 29 patients. Twenty-nine patients [80.6%] had pure or predominant stenosis and 7[19.4%] had pure regurgitation. No patient was in NYHA functional class I. Three patients [16.7%] were in functional class II, 15[83.3%] were in functional class II. The techniques used included closed mitral commissurotomy [16 patients], open mitral commissurotomy [13 patients], localized Wooler type annuloplasty [4 patients], suture repair of leaflet defect [3 patients], chordal shortening [1 patient], Carpentier ring annuloplasty [1 patient], and fenestration of fused chordae [1 patient]. There were two perioperative deaths [5.6%], related to left ventricular failure and reoperation. The survivors were followed up for 94 patient-years [mean 4.68*5.54 years]. One late death [1.1*1.1% per patient-year] occurred and was valve related. Reoperation was required in 3 patients, of whom 2 were deaths. There was 1 case [1.1*1.1% per patient-year] of thromboembolism. No patient received anticoagulant after operation. At 10 year, 92*7.4% of the patients were still alive. The actuarial survival rate of patients free of valve-related complication was 79*6.4% at 6 years, 27*12.1% at 11 years. After surgery, 18 patients [88.9%] were in NYHA functional class I or II.