The mitral plication suture: a new technique of mitral valve repair.

During 1975, 67 patients underwent attempted repair of mixed mitral valve disease by use of the new mitral plication suture (MPS) technique. Ninety per cent had successful repair and 10 par cent required valve replacement. The MPS is a double, semicircular, buttressed annuloplasty suture that constricts the enlarged mitral annulus to correct mitral regurgitation (MR), supports mitral subunit repair procedures, and yet maintains the flexibility of the mitral annulus. The hospital mortality rate was 6 per cent. There were no late deaths during 10.4 months of follow-up. Six per cent of the patients who had valve repair required subsequent MVR. Their repair operations are considered late failures. Echocardiography, a useful technique for assessing the status of the patients postoperatively, demonstrated normal mitral valve and left ventricular function in the majority of patients; comparisons with replacement valves are documented. Death and morbidity was less frequent than in patients with MVR, both in the hospital and during follow-up. The aggressive policy of mitral valve repair has reduced the number of MVR's from 95 during 1974 to 52 in 1975. Although follow-up is short, we conclude that the new MPS is a valid surgical adjunct to the complete repair of the mitral valve.