Mitral valvuloplasty at the Cleveland Clinic Foundation.

Abstract

In 1986, 273 patients at The Cleveland Clinic Foundation had surgery on their native mitral valves. Mitral insufficiency occurred in 153 (56.0%) of these patients, mitral stenosis in 70 (25.6%), and mixed lesions in 50 (18.3%). Valvular lesions were due to rheumatic valvulitis in 134 (49.1%) patients, degenerative mitral valve disease in 97 (35.5%), ischemia in 23 (8.4%), and varied causes, including bacterial endocarditis and congenital lesions, in the rest. There were 10 deaths in the entire series, a 3.7% operative mortality rate. Operative mortality was similar for mitral stenosis, mitral insufficiency, and mixed lesions. The low operative mortality rate and wide applicability of mitral valvuloplasty, which avoids the complications associated with a mitral valve prosthesis, should encourage surgical intervention before ventricular function deteriorates or atrial fibrillation becomes irreversible.