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The Annals of Thoracic Surgery, Vol 43, 52-58, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

The Puig-Massana-Shiley annuloplasty ring for mitral valve repair: experience in 126 patients

JP Murphy Jr, MS Sweeney and DA Cooley

Between October, 1982, and December, 1984, 126 patients at the Texas Heart Institute underwent mitral valve repair for mitral insufficiency utilizing the Puig-Massana-Shiley annuloplasty ring. Resection of a triangular-shaped wedge of the mural leaflet and direct suture repair was done in 42 patients, and anterior leaflet repair was used in 2 patients. There were 79 male (63%) and 47 female (37%) patients with a mean age of 58 years. Preoperatively, 95% were in New York Heart Association (NYHA) Functional Class III or IV. Concomitant cardiac operations were performed in 82 patients and included coronary artery bypass grafting (49%), aortic valve replacement (16%), repair of ventricular septal defect (2%), resection of left ventricular aneurysm (2%), and repair of atrial septal defect (1%). There were 8 early deaths (6.3%) and 11 late deaths (8.7%). In 44 patients undergoing mitral valve repair as an isolated primary procedure, operative mortality was 2.3%. Murmurs of mitral insufficiency were present in 5 patients postoperatively, but only 1 required early reoperation for mitral valve replacement. Follow-up data have been obtained on 80% of the patients. Postoperative Functional Class was obtained for 63 of the 82 surviving patients and showed 92% of these patients to be in NYHA Functional Class I or II. Mitral valve repair incorporating the Puig- Massana-Shiley annuloplasty ring and valve leaflet revision is a reliable technique that is not technically demanding. We believe these methods should be attempted for correction of pure mitral insufficiency, particularly in circumstances where other cardiac repairs are required.

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