Surgical Treatment of Mitral Insufficiency by Total Circumferential TPurse-String" Suture of the Mitral Ring

نویسندگان

  • ROBERT P. GLOVER
  • JULIO C. DAVILA
چکیده

SUCCESS in the surgical treatment of stenotic valvular disease of the heart has emphasized the urgency for the development of equally satisfactory methods for the correction of valvular insufficiencies. This need applies particularly to the mitral valve. Although mitral stenosis is quite common, it is relatively less so in the "pure" state. Bland stated that of 730 cases of rheumatic heart disease followed at the Good Samaritan Hospital in Boston, 128 (18 per cent) had mitral stenosis, 115 (16 per cent) had mitral insufficiency, and 398 (55 per cent) had a combination involving both lesions. The vast majority of patients undergoing surgery for mitral stenosis have some degree of well tolerated coexisting regurgitation.1 In a significant number of such cases the degree of regurgitation may be aggravated by surgery. In a few, serious regurgitation may be produced by a technically satisfactory commissurotomy. There are also many patients who cannot benefit from surgery for stenosis because of "too much" concomitant regurgitation. In these instances correction or control of the regurgitant factor is essential. The incidence of mitral insufficiency appears to be quite high.4 Most writers agree that the initial valvular lesion of rheumatic fever is insufficiency.5 Although the mortality of the acute rheumatic attack is relatively low, even in patients with definite carditis,6 as time goes on the toll

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تاریخ انتشار 2005