A Consideration of Operative Methods for Correction of Endocardial Cushion Defect

Abstract

Thirty-one patients with endocardial cushion defect (ECD) were studied postmortem from a surgical standpoint. From these studies, mitral valve tissue was found to be large enough to cover the whole area inside the mitral annulus in 22 patients. Forty-four of the 54 left ventricular angiocardiograms showed slight or no mitral insufficiency. Thus it is clear that a considerable number of patients with ECD do not require surgical repair of their valve despite the presence of a cleft. Closure of the ostium primum defect alone seemed to be sufficient for four-fifths of our patients with ECD. Only one-fifth of the patients were considered to require repair of their mitral valve. There is no standard operative method for ECD with severe mitral insufficiency. A new, more appropriate surgical approach was devised for these patients with severe regurgitation and has been used in 1 patient. The new method is described and our experience with it is presented.