Results of mitral valvuloplasty with a suture plication technique.

Between January, 1975, and October, 1978, a total of 243 patients underwent repair of the mitral valve with a suture plication technique. Mitral valve replacement (MVR) was performed in 36 cases in which significant residual regurgitation was apparent on testing the valve after repair. The hospital mortality rate was 5.7%. Five patients required MVR within 1 month of operation. A total of 190 patients were discharged from hospital with what was considered to be a satisfactorily functioning mitral valve. Excluding patients from overseas, detailed follow-up information is available in 80 cases. Of these 80 patients, 13 have subsequently undergone MVR. Factors favorably affecting survival and durability of repair are degenerative valve disease and age below 55 years. Clinical and echocardiographic assessment indicate that this method of repair initially produces good symptomatic improvement and a normal or nearly normal pattern of left ventricular filling. The good early results are only maintained in patients with degenerative valve disease. We therefore no longer use or recommend this technique for elderly patients with rheumatic valve disease.