Objective To study the clinical results and operative methods of mitral valvoplasty in patients of congenital heart disease with mitral insufficiency. Methods One hundred and twelve patients of congenital heart disease with mitral insufficiency had been treated with valve repair procedure. The surgery was performed under extracorporeal circulation and moderate hypothermia. Most of the patients were diagnosed atrioventricular septal defects (29 cases), ventricular septal defect (25 cases), patent ductus arteriosus (14 cases), and atrial septal defect (14 cases) before operation. The main pathologic characters of mitral valve were mitral valve annular dilatation (58 cases), leaflet lesions (37cases), anterior and posterior leaflet prolapse (36 cases). The surgery consisted of complex methods to repair mitral valves, including rings annuloplasty (22 cases), closure of the commissure (18 cases), double-orifice method (14 cases), chords reimplantation and so on. Results Seventy two patientshad 0 to I class mitral valve regurgitation and 26 patients had Ⅱ class mitral valve regurgitation during the retrial period by echocardiography, only one case needed re-operation. The patients with left ventricular end diastolic diameter (LVEDD) more than 45mm had a reduction of left atrial diameter (from 45.8±10.7mm to 34.4±8.9mm, t=6.53, 7.89,(Plt;)0.001) and left ventricular diameter (from 58.6±10.9 mm to 44.3±8.5 mm, t=7.89, Plt;0.001) after operation. Conclusions Surgical operation on mitral valve regurgitation of congenital heart defect is a benefit and a compound method and transesophageal echocardiography may help the surgeon in estimating the surgical efficacy during operation.
ObjectiveTo evaluate outcomes of mitral valvuloplasty with artificial chord and mitral annuloplasty ring in patients with mitral valve prolapse. MethodsFrom January 2012 to March 2014, mitral valvuloplasty with artificial chord and mitral annuloplasty ring were performed for 58 patients with mitral valve prolapsed in Department of Cardiovascular Surgery, Fujian Provincial Hospital, among which 47 simple anterior or posterior mitral valvuloplasty and 11 combined anterior-posterior mitral valvuloplasty were completed. There were 33 males and 25 females aged (53.7±14.3) years. ResultsThere was no in-hospital death. Three patients received mitral valve replacement. The transoesophageal echocardiography found no or trivial mitral regurgitation in 48 patients, mild mitral regurgitation in 7 patients. The diameter of the left atrium (LA) and left ventricle (LV), left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) were significantly decreased after the operation. During the follow-up of 6 months to 2 years, the cardiac function of the patients improved. ConclusionMitral valvuloplasty with artificial chord and mitral annuloplasty ring is simple, reliable and effective treatment for patients with mitral valve prolapse, and its shortand mid-term outcome is good.