Abstract:

Purpose: Mitral valve reconstruction is the treatment of choice in mitral regurgitation. In this study, the causes of reoperation following mitral reconstruction with Carpentier ring annuloplasty are discussed. Material and Method: Five patients who underwent reoperation late after mitral ring annuloplasty with Carpentier ring were reviewed. Patients were all female, mean age was 44.6+11.2 (range 32 58 years) and the mean interval between the two procedures was 32+28.4 (range 7-78) months. All patients had history of rheumatic fever. Prior to mitral reconstruction, four patients had moderate to severe mitral regurgitation, one patient had severe mitral stenosis. Associated procedures were aortic valve replacement in one patient, tricuspid annuloplasty in four patients during mitral reconstruction. Indications for reoperation were severe mitral regurgitation in three patients and third degree regurgitation with mitral stenosis in two. Results: The reasons for reoperation for the failed mitral reconstruction were procedure related in one patient and progression of the rheumatic disease in four patients. All patients underwent mitral valve replacement with mechanical bileaflet prosthesis. Associated procedures were aortic valve re-replacement in one patient, tricuspid annuloplasty in all five patients, ring was used in two. One patient died in hospital. In early follow-up, all four surviving patients were found to be in NYHA functional class I-II and have normally functioning mitral prosthesis. One patient had minimal, three patients had moderate tricuspid regurgitation. Conclusion: This study considered that the reason for reoperation for failed mitral reconstruction is mainly related with the progression of mitral valve pathology or inadequate surgical technique and early results of reoperation of these patients are good.

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