Open Mitral Valve Reconstruction

Of 232 mitral valve reconstructions performed from 1964 through 1969, 142 were univalvular. With the 87 repairs for mitral insufficiency, five hospital deaths occurred (5.7%); follow-up of 76 survivors showed 61 improved patients (80.3% of 76), seven unimproved (six required valve replacement), and eight late deaths. Eight of the 15 failures were due to persistent or recurrent mitral insufficiency. With 55 open commissurotomies for mitral stenosis, three hospital deaths occurred (5.5%); follow-up of 47 survivors disclosed 42 improved patients (89.4%), four unimproved (three required valve replacement for mitral disease), and one late death. With 90 mitral valve reconstructions done in multivalvular procedures or with coronary artery grafting, there were nine hospital deaths (10%). The low mortality and excellent palliation with mitral valve reconstruction favor its use over valve replacement in properly selected cases.