Valve repair for rheumatic mitral disease

Background and aim of study: Mitral valve repair is the standard reparative technique for degenerative mitral disease, but results of valve repair in rheumatic disease are also encouraging. The outcomes after mitral valve rep air for rheumatic disease at young age was evaluated for suitability of rep air. Methods: A total of 319 patients (246 females, 73 males; mean age 31.3 +/- 0.5 years) underwent mitral valve repair for rheumatic mitral disease at th e authors' institution between 1991 and 1998. Mean follow up was 51.9 +/- 1 .2 months (range: 9-98 months), and was 88.7% complete. Results: Preoperatively, 47.6% of patients were in NYHA classes III and IV. Mitral stenosis was present in 87.5%, insufficiency in 5.3%, and stenosis/ insufficiency in 7.2%. Concomitant procedures were performed in 32% of pati ents who had associated cardiac lesions. The intraoperative mortality, reop eration and reoperation mortality rates were 0.9%, 6.7% and 0%, respectivel y. During follow up there were 10 late deaths (3.5%), six of which were car diac disease-related (2.1%). Postoperatively, 98% of patients were in NYHA classes I and II. Conclusion: Valve repair in mitral disease is a standard technique, with lo w mortality, complication and reoperation rates, and good cardiac function and late survival. This approach is equally applicable to rheumatic mitral valve repair; hence, rheumatic mitral valves should also be repaired.