PMID- 1467039
OWN - NLM
STAT- MEDLINE
DCOM- 19930128
LR  - 20190503
IS  - 0007-0769 (Print)
IS  - 0007-0769 (Linking)
VI  - 68
IP  - 5
DP  - 1992 Nov
TI  - Conservative surgery of the mitral valve: a report of the first 100 cases from 
      one unit and one surgeon.
PG  - 505-9
AB  - OBJECTIVE: To report the first 100 mitral valve repairs performed in a unit with 
      an aggressive approach to conservative mitral valve surgery. DESIGN: Case notes 
      were reviewed retrospectively and patients invited for clinical examination and 
      cross sectional and Doppler echocardiography. SETTING: Tertiary cardiothoracic 
      referral centre. PATIENTS: Between December 1985 and April 1991 mitral valve 
      repair was carried out on 100 patients (66 males). Patients with pure mitral 
      stenosis were excluded. Sixty seven had degenerative and 15 rheumatic mitral 
      valve disease. Median age was 66 (range 12 to 79) years, with an interquartile 
      range of 59 to 71 years. INTERVENTIONS: Operative procedures included 
      annuloplasty ring in 97, resection of the posterior leaflet in 67, resection of 
      endocarditic portion of posterior leaflet in four, commissurotomy in six, and 
      correction of anterior leaflet abnormalities in seven. Thirty nine concomitant 
      cardiac procedures were performed in 32 patients. Six operations were 
      emergencies, and three of these required concomitant procedures. MAIN OUTCOME 
      MEASURES: Mortality, operative failure rate, patients' functional state and 
      degree of residual mitral regurgitation, incidence of thromboembolism, and 
      endocarditis. RESULTS: Follow up ranged from one to 59 months, median 14 months, 
      and an interquartile range of four to 23.5 months. Early mortality was 1%, late 
      mortality 5%, and there was a 2% reoperation rate. Eighty four patients had 
      moderate to severe mitral regurgitation preoperatively. At follow up mitral 
      regurgitation was absent or mild in 78. Eighty six patients were in New York 
      Heart Association (NYHA) class I-II at follow up compared with 80 in NYHA class 
      III-IV preoperatively. There were no thromboembolic events. CONCLUSION: This 
      study shows that satisfactory results can be obtained with mitral valve repair in 
      a fairly elderly population with a high incidence of concomitant cardiac 
      disorders. We suggest that these encouraging results will lead to earlier mitral 
      valve repair in mitral regurgitation.
FAU - Kenny, A
AU  - Kenny A
AD  - Cardiac Unit, Papworth Hospital, Cambridgeshire.
FAU - Fuller, C A
AU  - Fuller CA
FAU - Shapiro, L M
AU  - Shapiro LM
FAU - Wells, F C
AU  - Wells FC
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br Heart J
JT  - British heart journal
JID - 0370634
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/diagnostic imaging/*surgery
MH  - Mitral Valve Insufficiency/diagnostic imaging/mortality/*surgery
MH  - Retrospective Studies
PMC - PMC1025198
EDAT- 1992/11/01 00:00
MHDA- 1992/11/01 00:01
PMCR- 1992/11/01
CRDT- 1992/11/01 00:00
PHST- 1992/11/01 00:00 [pubmed]
PHST- 1992/11/01 00:01 [medline]
PHST- 1992/11/01 00:00 [entrez]
PHST- 1992/11/01 00:00 [pmc-release]
AID - 10.1136/hrt.68.11.505 [doi]
PST - ppublish
SO  - Br Heart J. 1992 Nov;68(5):505-9. doi: 10.1136/hrt.68.11.505.