PMID- 7354634
OWN - NLM
STAT- MEDLINE
DCOM- 19800426
LR  - 20071115
IS  - 0022-5223 (Print)
IS  - 0022-5223 (Linking)
VI  - 79
IP  - 3
DP  - 1980 Mar
TI  - Reconstructive surgery of mitral valve incompetence: ten-year appraisal.
PG  - 338-48
AB  - Between January, 1969, and January, 1978, 551 patients with mitral incompetence 
      were treated by a system of reconstructive techniques. Mitral valve incompetence 
      was classified into three types according to leaflet pliability; type I normal 
      leaflet motion, 150 cases; type II, leaflet prolapse, 213 cases; and type III, 
      restricted leaflet motion, 188 cases. Associated tricuspid valvular disease was 
      present in 174 cases (31.5%) and was treated by prosthetic ring annuloplasty. The 
      operative mortality rate was 4.2% (16/377) in the mitral group and 14% (25/174) 
      in the mitral-tricuspid group. Follow-up data are available in 341 patients from 
      1 year to 10 years (average 4 1/2 years). The late mortality rate was 7% 
      (24/341). Actuarial curves including hospital mortality rate show an 82% survival 
      rate at 9 years in the mitral group and a 79% rate in the mitral-tricuspid group. 
      Thirty-seven patients (11%) underwent reoperation mainly for residual (17) or 
      recurrent (16) mitral incompetence. Thromboembolism occurred in 12 patients for 
      an embolic rate of 0.6% per patient-year, even though 48% were not given 
      anticoagulants. Acorrding to the New York Heart Association (N.Y.H.A.) 
      classification, 76% (207/270) of the patients were in Class I, 19% (51/270) were 
      in Class II, 4% (10/270) were in Class III, and 0.7% were in Class IV (2/270). 
      Results of postoperative catheterization and angiocardiography are available in 
      52 patients. Comparison between the various groups shows that the best results 
      were obtained in type II mitral incompetence, followed by type I and type III 
      mitral incompetence. This experience demonstrates that predictable and stable 
      long-term results have been achieved by techniques of valvular reconstruction 
      with a low incidence of thromboembolism. Reproducibility of the techniques is a 
      limiting factor which can be overcome by adequate training and progressive 
      experience. Patient selection is based on the valvular disease rather than age, 
      physical condition, or cause of valvular disease.
FAU - Carpentier, A
AU  - Carpentier A
FAU - Chauvaud, S
AU  - Chauvaud S
FAU - Fabiani, J N
AU  - Fabiani JN
FAU - Deloche, A
AU  - Deloche A
FAU - Relland, J
AU  - Relland J
FAU - Lessana, A
AU  - Lessana A
FAU - D'Allaines, C
AU  - D'Allaines C
FAU - Blondeau, P
AU  - Blondeau P
FAU - Piwnica, A
AU  - Piwnica A
FAU - Dubost, C
AU  - Dubost C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Thorac Cardiovasc Surg
JT  - The Journal of thoracic and cardiovascular surgery
JID - 0376343
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Endocardial Fibroelastosis/surgery
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis
MH  - Hemodynamics
MH  - Humans
MH  - Middle Aged
MH  - Mitral Valve/physiopathology
MH  - Mitral Valve Insufficiency/*surgery
MH  - Mitral Valve Stenosis/surgery
MH  - Postoperative Complications/mortality/surgery
MH  - Rheumatic Heart Disease/surgery
MH  - Thromboembolism/mortality
MH  - Tricuspid Valve Insufficiency/surgery
EDAT- 1980/03/01 00:00
MHDA- 1980/03/01 00:01
CRDT- 1980/03/01 00:00
PHST- 1980/03/01 00:00 [pubmed]
PHST- 1980/03/01 00:01 [medline]
PHST- 1980/03/01 00:00 [entrez]
PST - ppublish
SO  - J Thorac Cardiovasc Surg. 1980 Mar;79(3):338-48.