From September 1988 to July 1990, 56 patients under 20 years of age (mean 12.7 ± 5.12 years) with pure or predominant mitral valve regurgitation secondary to rheumatic valve disease, underwent mitral valvuloplasty. Ninety-three percent of the patients were in functional class III ou IV (NYHA). The basic surgical technique used in all patients was a modified measured assy metric anuloplasty which was associated in 69.7% of the cases with another plastic procedure. Intraoperative echodopplercardiography was always used and showed a good correlation with the postoperatoty echo studies, with 64% of the patients free from residual lesions. There was no hospitalar mortality. Fifty-three (94.6%) patients were followed from 1 to 40 months (mean 16.3%). There was one sudden death 3 months after the operation. Four patients were reoperated upon, 3 of whom due to recurrent rheumatic carditis. The remainder are in functional class I or II (NYHA). We conclude based on these early results that assymetric mitral anuloplasty is an excellent procedure for young patients with rheumatic heart disease, being a good alternative to valve replacement or ring implantations.
mitral valve; rheumatic heart disease; mitral valve