The surgical strategie in mitral valve disease is important in young patients particularly in women of child-bearing age according to reoperation risk. In this study, the late term results of mitral reconstruction and mitral bioprosthetic valve replacement were investigated retrospectively with regarding to reoperation rate and interval.

In Koşuyolu Heart and Research Hospital, 437 patients (306 female and 131 male, the maen age 34.6) underwent mitral reconstruction, and 450 patients (328 female and 122 male, the maen age 32.1) underwent mitral bioprosthetic valve replacement procedure in a thirteen-year period between April 1985 to October 1998. Mitral valvuloplasty techniques consisted of annuloplasty in 309 patients (prosthetic ring annuloplasty in 89, Kay annuloplasty in 122, Wooler annuloplasty in 34, and the other modified annuloplasty techniques in 64), augmentation of mitral leaflets in 48 patients (extension of posterior leatlet in 47, repair of anterior leaflet perforation in 1), the restriction of increased mitral valve mobility in 47 patients (the quadrangular resection of posterior leaflet in 21, the shortening of elongated chordae in 20, the transfer of chordae tendinea in 6).

The reoperation rate of mitral valve reconstruction group was 10.5% with 2.3 years reoperation interval in 46 patients and the reoperation rate of bioprosthetic valve replacement group was 15.3% with 6.2 years reoperation interval in 69 patients. A complete follow-up possible in 87% patients with a mean observation time of 51.6 months (1522 patient-years) in mitral valve reconstruction group and a complete follow-up possible in 81% patients with a mean observation time of 68.5 months (2084 patient-years) in bioprosthetic valve replacement group. Five-year reoperation free rates were found 89.7% in mitral reconstruction and 84.6% in mitral bioprosthetic valve replacement.

Our instutional policy is that mitral valvuloplasty should be tried if possible because of its more physiological approach. These experiences indicate that mitral repair procedures are effective surgical approaches especıally young patients when compared bioprosthetic valve replacement.

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