Valve repair for mitral regurgitation--early and late results

Mitral valve repair for regurgitation has many advantages over mitral valve replacement. However, durability and reoperation after repair still remain major problems. We examined the outcome of mitral repair for valve regurgitation and analyzed several pre- and intraoperative factors to determine their impact on mortality and morbidity.

Methods: From January 1990 to December 2000, 69 patients underwent mitral valve repair. The mean age was 52.8 years, and 82.6% were NYHA class III or IV. The causes of mitral valve disease were ischemic in 32, rheumatic in 20 and degenerative in 17 patients. Mitral valve repair was accomplished by Carpentier's techniques, Key commisuroplasty and ring implantation.

Results: There were 5 early and 6 late deaths in the ischemic group and no early mortality and two late deaths in the mixed rheumatic and degenerative group. Seven patients needed reoperation, 4 in the ischemic group and 3 with rheumatic disease. Actuarial overall survival at 5 years was 100% in rheumatic, 86% in degenerative and 75% in ischemic patients.

Conclusions: Mitral valve repair for mitral regurgitation provides excellent results and long-term survival in rheumatic and degenerative disease. The ischemic etiology is the most important predictor for early death and poor long term survival.