Background: The number of mitral valve reconstructions performed has increased during recent years in our hospital. We evaluated the early results of reconstructions without the use of a mitral annular ring in the treatment of degenerative mitral valve insufficiency.

Methods: Fourteen patients (8 men, 6 women; mean age 46.6 years; range 18 to 71 years) with degenerative mitral valve insufficiency underwent posterior suture annuloplasty without the use of a mitral annular ring. Preoperative functional capacity of the patients was class III or IV. Five patients had associated atherosclerotic coronary artery disease. Three patients had mild aortic valve insufficiency, secundum atrial septal defect, and tricuspid valve insufficiency, respectively. Eight patients had posterior and five patients had anterior mitral leaflet prolapse. In addition, four patients had annular dilatation.

Results: One patient (7.6%) died on the postoperative 17th day due to infection and cardiopulmonary insufficiency. One patient underwent mitral valve replacement due to unsuccessful mitral valve repair. Transesophageal echocardiography showed mitral insufficiency of grade I (+). After the operation, three patients required inotropic support, and two patients required intra–aortic balloon support. The mean durations of aortic clamping and cardiopulmonary bypass were 89±33 min and 128±50 min, respectively. Intensive care unit stay and hospital stay were 2.7±4.4 days (range 1 to 17 days) and 5.6±3.2 days (range 2 to 15 days), respectively.

Conclusion: We concluded that early postoperative course of mitral valve repair with posterior suture annuloplasty without using a prosthetic ring was satisfactory in degenerative mitral valve diseases. However, the actual applicability of the technique should be validated by mid-term and long-term results.

Keywords : Heart valves/pathology/surgery; mitral valve/surgery; mitral valve insufficiency/surgery; mitral valve prolapse/surgery; suture techniques