Surgical Treatment of Mitral Regurgitation Associated with Enlarged Left Ventricle
Li Wenbin, Zhang Jianqun, Zhou Qiwen, Chen Baotian, Xu Xiufang, Zhang Zhaogguang, Zhang Wukui

Between April 1988 and September 2000, 45 patients with mitral regurgitation (MR) underwent mitral valve replacement (MVR). All patients had left ventricular (LV) diastolic diameter (LVDD) >70 mm. Echocardiography showed severe MR and LV hypertrophy in all cases: mean LVDD was 76.3 ± 4.1 mm. MVR was performed under hypothermic cardiopulmonary bypass. Operative mortality was 4%. Follow up was complete in 37 patients (82%). Mean follow up was 1711 days (range: 30-4,500 days). Nine patients were in NYHA class I, 21 in class II, and five in class III. Late mortality was 5%. LVDD was further decreased from 76.3 ± 6.5 to 60.0 ± 6.1 mm (p <0.001). In conclusion, MVR is indicated in patients with mitral insufficiency and highly dilated ventricles. Moreover, perioperative mortality is acceptable and late results satisfactory, and the intervention may (potentially) reduce (and in some cases normalize) severe LV dilation.