Durability of measured mitral annuloplasty: seventeen-year study.

This report describes the technique and results of measured mitral annuloplasty performed in 196 patients having isolated mitral valve disease during the 17 years between January, 1961, and January, 1978. These patients represent 35% of all of those operated upon for isolated mitral valve disease during this period. Ages ranged from 3 to 70 years. Annuloplasty was performed in 115 patients and both commissurotomy and annuloplasty in another 81 patients. The operative mortality rate was 4.5% and the late mortality rate 8.7%. There were six arterial embolic episodes during the 17 years. Reoperation was required in 8% with another repair of the valve being possible in one third of them. This study suggests that measured repair of mitral regurgitation resulted in lower operative mortality, late mortality, and incidence of embolization when contrasted with mitral valve replacement. This operation appears to be the preferred procedure for certain subsets of patients (1) who require operation during infancy or childhood, including during active carditis; (2) who require operation during the childbearing age; and (3) in whom anticoagulation poses a severe threat to life or quality of life.