REPAIR OF MITRAL REGURGITATION FROM MYXOMATOUS DEGENERATION IN THE PATIENT WITH A SEVERELY CALCIFIED POSTERIOR ANNULUS

Severe posterior annular calcification poses a particular challenge to mitral valve repair. In a series of 252 mitral valve repairs for myxo matous degeneration performed between 1980 and 1993, 14 patients had a severely calcified posterior mitral valve annulus. Ages ranged from 6 1 to 81 years. Twelve patients were preoperative NYHA Class III or IV, and five patients required concurrent coronary artery bypass procedur es. Operative techniques included complete resection of the calcified posterior annulus, resections of portions of the posterior leaflet wit h leaflet advancement, and placement of an annuloplasty ring. There we re no operative deaths and all patients had a postoperative echocardio graphic confirmation of relief from mitral regurgitation. During a mea n follow-up time of 36 months (6 months to 8 years), there has been on e late valve reoperation and only one late death, from thromboembolism in a patient with atrial fibrillation. These data indicate that even in the presence of severe calcification of the posterior mitral annulu s, mitral valve repair for myxomatous degeneration can be performed wi th a low-operative risk and satisfactory long-term results.