One hundred and fifty-five patients with isolated mitral regurgitation were referred from our Department of Cardiology for mitral valve repair between 1972 and 1990. Men were in the majority (59 %), the mean age was 51 years and 61 % of the patients were in NYHA class III or IV. Degenerative or dystrophic etiologies predominated, followed by rheumatic origins (17 %) and bacterial endocarditis (14 %). Surgical repair was performed using Carpentier's techniques: insertion of a prosthetic ring (87 %), valvular resection (73 %), valvular mobilization (11 %), closure of a perforation (4,5 %) and resection of vegetations (4,5 %). Two patients died during surgery and 7 were lost to follow-up; the others were followed for an average of 4 years, i.e., a cumulative follow-up of 584 years/patients. The overall results at 11.5 years were satisfactory: 84.5 % survival rate and 64.5 % with good valvular function. The linearized rates of endocarditis, thromboemboli, hemorrhagic complications (51 patients were taking anticoagulants) and repeated interventions were, respectively: 0.35, 1.54, 0.17 and 2.05 %/patient-year. Residual mitral regurgitation was sought by clinical and Doppler examinations: 55.5 % of the patients had none, 26 % had mild, 10.3 % had moderate and 8.2 % had severe regurgitation. Analysis of the latter two groups identified 3 influencing factors: rheumatic origin of the regurgitation, surgery on the anterior cusp and the year surgery was performed (the post-surgical incidence has decreased in recent years). Other, less-well-known complications were also found: left ventricular outflow tract obstruction, progressive evolution towards mitral stenosis, development of aortic regurgitation (usually discreet) and formation of left atrial thrombi. Among the 22 patients undergoing surgery for mitral valve endocarditis, 6 during the acute phase of the disease and 4 with extremely large vegetations, no deaths and no endocarditis relapses occurred, and only one case of severe residual regurgitation was observed. In light of these results, valvoplasty seems to be the treatment of choice for non-ischemic mitral regurgitation, particularly in patients with mitral valve endocarditis.
