Mitral valve annuloplasty with a bovine pericardial strip--18-year results.

PURPOSE Prosthetic annuloplasty rings are currently used in mitral reconstruction. Posterior annuloplasty with a bovine pericardial strip is a technique largely used in the Heart Institute of University of São Paulo Medical School. The purpose of the study was to analyze the late results of mitral valve repair with posterior annuloplasty using a bovine pericardial strip. METHODS Between January 1984 and December 2002, 273 patients underwent mitral valve repair with posterior pericardial annuloplasty in the Heart Institute of University of São Paulo Medical School. One hundred and forty four (52.7%) were women and ages ranged between 1 and 76 years (38.3 +/- 21.1). Rheumatic fever was present in 52.0% of the patients. Associated techniques were employed in 26.0% of the patients, and the most frequent was chordal shortening (9.2%). RESULTS Hospital mortality was 3.3% (9 patients), with the major cause being low cardiac output (6 patients). Actuarial survival was 55.1% +/- 16.8% in 18 years. During the 18-year follow-up: patients were free from the following: reoperation (59.1% +/- 13.9%, (percent +/- Standard Error), thromboembolism (97.4% +/- 2.3%), hemolysis (99.2% +/- 0.2%), and endocarditis (99.6% +/- 1.0%). In the late follow-up period, 83.9% were classified as New York Heart Association functional class I. CONCLUSIONS Late results with mitral valve repair with posterior annuloplasty using a bovine pericardial strip were satisfactory. The technique is feasible, reproducible, and cost effective.