Mitral valvuloplasty with sutures used for aortic prosthesis implantation.

Abstract

The purpose of this study was to analyze surgical treatment for aortic valve lesions with coexisting mitral regurgitation (MR). Seventy-five patients were divided into two groups according to intensity of MR (group 1, MR less than or equal to II; group 2, MR greater than or equal to II/III). There were two control groups (control 1, only patients with implantation of aortic valve; control 2, patients with implantation of both aortic and mitral prostheses). During implantation of a mechanical aortic prosthesis, the same suture for fixation of a mechanical prosthesis and for suspension of mitral commissural regions and lifting the base of anterior mitral cusp was used. In all patients, no early death occurred. There were two late deaths, one due to endocarditis, and the other to heart failure. All patients from both groups had decreased MR. Selected echocardiographic parameters improved: end diastolic and end systolic diameter and ejection fraction in group 2 improved in proportion to patients in whom mitral valves were implanted (control 2). Simultaneous suspension of the mitral commissure area during mechanical aortic prosthesis implantation reduces associated MR. This technique seems to be efficient during implantation of aortic prostheses in patients with coexisting MR.