Prophylactic mitral reconstruction for mitral regurgitation

Background. Mitral regurgitation (MR) will produce myocardial dysfunction. The goal of this study was to review outcomes of mitral valve reconstructio n in asymptomatic patients with severe MR. Methods. From 1992 to 2000, 93 asymptomatic patients with degenerative dise ase and severe MR underwent mitral valve reconstruction. Mean preoperative left ventricular internal diameter diastole was 56 +/- 8 mm and ejection fr action was 60% +/- 6%. Mean age was 47 +/- 10 years and mean follow-up 23 /- 27 months. All patients underwent complex reconstruction. Results. There were no deaths and two late reoperations. One was for systol ic anterior motion of the anterior leaflet of the mitral valve requiring va lve replacement and one for hemolysis requiring re-repair. There was one pe rioperative transient ischemic attack and no late thromboembolic events. At follow-up all but 1 patient remains in NYHA class I and all had no MR exce pt in 2 patients at 63 and 89 months. Conclusions. Mitral valve reconstruction for "asymptomatic" MR can be perfo rmed with no mortality and low morbidity before development of left ventric ular dysfunction. Early prophylactic repair is advocated in the presence of severe MR if valve reparability is assured. (C) 2001 by The Society of Tho racic Surgeons.