RACIONALE: Most surgical intervention on the mitral valve in Brazil are due to rheumatic cardiac disease (RCD). Some advantages of the mitral valve repair over replacement are lower operative and late mortality, maintenance of geometry and left ventricular function. Nevertheless, the evolution of the RCD can jeopardize the late results of mitral reconstruction. OBJECTIVE: The objective of this study is to compare the results of mitral valve repair for isolated regurgitation in our patients with RCD and myxomatous degeneration (MD). MATERIAL AND METHODS: Charts from patients with RCD (n = 11), and MD (n = 9) submitted to mitral repair between July 1992 and August 1999 were reviewed. Twenty six mitral procedures were performed on patients with MD, and 31 on those with RCD. Bovine pericardial ring was used for anuloplasty on 18 patients, and rigid (Carpentier) ring on 2 (one in each group). The techniques were quadrangular ressection (n = 13), trench shortening (n = 5), comissurotomy (n = 4), leaflet extention (n = 3), chordal transposition (n = 3), chordal replacement (n = 2), papilotomy (n = 2), chordal plication (n = 1), and folding plasty (n = 1). RESULTS: Mean follow-up was 41.5 months (6 to 96 months), and one patient was lost. There were no hospital or late deaths. One patient with RCD were reoperated for disease evolution. One patient was treated concervatively for endocaditis 3 months after surgery. The difference on left ventricular diameter, both systolic and diastolic, did not reach statistical significance (p = 0.20; p = 0.17, respectively). CONCLUSION: In conclusion, the mid-term (3.4 years) results for mitral valve repair due to isolated regurgitation were satisfactory in both groups. Clinical follow-up of patiens with RCD was comparable to those with MD in respect to operative and late death, endocarditis, and valve related events.
Mitral valve; Mitral valve; Rheumatic fever; Rheumatic heart
