Conservative Surgery of the Mitral Valve: An Echocardiographic Long-Term Evaluation

Conservative surgery of the mitral valve is a very appealing procedure. In the last 3 years (1984–1987), 40 patients, aged 11 to 72 years (mean age of 46,33 years), underwent mitral repair in our department, alone or in combination with other surgical procedures. Seventeen patients had mitral insufficiency (M.I.), (five congenital and 12 acquired), while 23 had mitral stenosis. All the patients had preoperative echocardiographic evaluation. Surgical procedures included open commissurotomy in 23 patients (57.5%), reconstruction of the septal commissure in five (12.5%), quandrangular resection for posterior leaflet prolapse in seven (17.5%), and repair of annulus dilatation by means of annuloplasty in five (12.5%). No hospital deaths were observed. All the patients entered a follow-up study in which 2D echocardiography and Doppler echocardiography were used to assess the long-term results of the procedures. After a mean follow-up of 36 months, the results can be summarized as follows: Mitral stenosis: good 73.9%; fair 26.1%; bad 0%. Mitral insufficiency: good (no regurgitation) 65%; fair (mild regurgitation) 25%; bad (waiting for valve replacement) 10%.