MITRAL VALVE REPAIR IN A RHEUMATIC POPULATION: AN EXPERIENCE AT AFIC/ NIHD

Mitral Valve Repair

Abstract

Objective: To analyze the outcome of mitral valve repair in rheumatic heart disease.
Study Design: Retrospective analytical.
Place and Duration of Study: Armed forces institute of cardiology/National institute of heart diseases Rawalpindi from Jan 2011 to June 2013.
Material and Methods: In this retrospective study of 28 patients (15 females). The mean age was 20.2 ± 11.2 years (range, 11 to 55 years). The cause of mitral regurgitation was rheumatic in all patients, with no congenital myxomatous, infective or ischemic cases. About 68% patients were in New York Heart Association (NYHA) functional class III or IV. In all the cases posterior ring annuloplasty was done with flexible C- Shape rings with size ranging from 20 to 26 mm. Repairs included anterior leaflet repair with cusp shortening & resuspension (n=17), posterior leaflet repair with quardranguloplasty & transpositioning (n=6), commissuroplasty (n=2) and mixed anterior posterior leaflet repair (n=3).
Results: There was no operative mortality. Follow-up was carried out for 10 months. The trivial mitral regurgitation was found in 3 cases (10.7%). Four (14.2 %) patients required mitral valve replacement due to valve dysfunction.
Conclusion: Mitral valve repair in rheumatic patients, with current techniques, can effectively correct functional and hemodynamic abnormalities with satisfactory results.