Methods: This clinical study included the first 100 consecutive patients (46 males, 54 females; mean age 52.1±15.5 years; range 16 to 77 years) who underwent mitral repair. Pathologies were rheumatic (n=44), ischemic (n=30), myxomatous (n=29), and chordal rupture (n=7). Mitral annuloplasty ring was used routinely. Concomitant procedures were performed in 79% of patients including coronary artery bypass grafting (n=35) and tricuspid ring annuloplasty (n=34). Postoperative complications were recorded. Echocardiographic examinations were performed at discharge and during follow-up. Kaplan- Meier analysis was used to estimate overall survival and from residual severe MR, thromboembolization, endocarditis and reoperation-free survival rates.

Results: Early (30 days) mortality developed in five patients due to low cardiac output and sepsis. At discharge, echocardiography revealed none/trivial MR in 59.5%, mild MR in 30.8%, and moderate MR in 5.3% of patients. The mean follow-up was 22.7±5.8 months in 94 patients. During follow-up, transthoracic echocardiography showed mild MR in 96.6% patients. Only two patients (2.1%) presented with severe MR due to endocarditis and ischemic disease. The mean left ventricular end-systolic (p=0.01) and end-diastolic diameters (p<0.05) decreased postoperatively. Kaplan-Meier estimates showed that death, severe MR, thromboembolization, endocarditis, MR recurrence and reoperation-free survival rates were 94.0±2.3%, 96.9±2.2%, 98.4±1.5%, 98.9±1.1%, 96.9±2.2%, and 98.9±1.1% at postoperative 30 months, respectively.

Conclusion: Mitral repair is a successful and effective procedure in the treatment of distinct mitral valve pathologies and complex lesions.