Clinical and haemodynamic results of mitral annuloplasty.

Clinical results were evaluated 6 months to I4 years after mitral annuloplasty in 89 operative survivors. Before operation, 13 patients were grade 2, 63 grade 3, and I3 grade 4 (N. Y.H.A. classification). After operation all patients were improved symptomatically. Sixty-one patients were grade I, 27 grade 2, and I patient grade 3. Early clinical deterioration occurred in 5 patients, caused by dehiscence of annuloplasty in 3, and by infective endocarditis in 2, within six months of the operation. Progression of mitral valve disease was responsible for late deterioration I to 8 years after mitral annuloplasty in 23 patients. Sixteen needed mitral valve replacement. There were 12 deaths, including 6 after reoperation. Actuarial analysis showed go per cent survival with annuloplasty at 5 years' and 6o per cent at I0 years' follow-up. Late systemic embolism occurred in only 3 cases though anticoagulants were not used. Haemodynamic studies in I4 unselected patients, 5 to II years after annuloplasty, showed significant reduction in pulmonary wedge andpulmonary arterialpressure when compared with the preoperative values. In view of the satisfactory long-term clinical results, as observed in this study, mitral annuloplasty merits consideration in the surgical treatment ofmitral regurgitation.