الفهرس 
Anatomy of the mitral valveOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND CONCLUSION
Perfection and innovation of surgical techniques allawed to reach good early postoperative and mid-term results in mitral valve repair.
The aim of the surgery is to restore the functional integrity of the valve rather than its normal anatomy, taking in consideration the normal valve geometry in order to ensure durability of the repair. Mitral valve repair has become the procedure of choice for mitral valve regurgitation.
This study aimed to assess the results of mitral valve repair in different pathological etiologies, and its effect on the left ventricular function.
The study was done in the Cardiothoracic department of Ain Shams University hospitals in Egypt, and the Cardiovascular and thoracic surgery department of Rouen University in France, between March 2002 and November 2004.
We operated upon 40 adult patients who suffered from mitral valve regurgitation. We excluded the patients who had previous cardiac surgery, patients with associated aortic or tricuspid valve surgery.
The mean age was 43.8 years (ranged from 15 to 78 years). The female patients were 52% of the total number of the patients. The etiology of mitral valve regurgitation was mainly due to rheumatic heart disease (42.5%), the patients symptoms were mainly dyspnea (70%).
There were no great difference between the results of the preoperative ECHO assessment and the intraoperative direct vision assessment, the most common mechanisms of mitral regurgitation were annular dilatation in (82.5%) of the patients.
We used variable methods of operative repair, annuloplasty was used in all the patients. The commonly used ring sizes were 30 & 32.
As regard the post-operative echocardiography assessment we found that, most of the patients (87,5%) had no or trivial mitral valve regurgitation, the mean transvalvular pressure gradient DROPped from 7.35±0.93 to 4.56±1.12 mmHg, and the mitral valve area increased from 1.83±0.35 to 2.33±0.18 cm², accompanied by a marked reduction of the pulmonary artery pressure.
There was no early hospital mortality, there was (2.5%) of late mortality within the first postoperative year, we had a success rate of freedom from reoperation of (97.5%) within the first six months, and a freedom from reoperation of (95%) at the first postoperative year.
We conclude that mitral valve repair surgery is a safe procedure that preserve the ventricular function, has acceptable rate of freedom from reoperation, with acceptable early and late mortality rate, Echocardiography nowadays is a good preoperative assessment tool in detecting the mechanism of mitral valve regurgitation.