To summarize and retrospectively analyze the clinical efficacy of mitral valvuloplasty (MVP) in patients with moderate to severe mitral regurgitation (MR).

From June 2013 to June 2017, 28 patients with MR who underwent MVP were admitted to the Department of Cardiothoracic Surgery, Shuyang Hospital of Xuzhou Medical University and they were used as study objects to conduct a retrospective case analysis. Among them, there were 17 males and 11 females, aged from 50 to 72 (61.5±10.6) years. All patients had obvious clinical symptoms before the operation, and the presence of moderate to severe MR was confirmed by echocardiography. Before surgery, we evaluated and selected feasible MVP surgery and combined surgery according to the patient’s comorbidities, location of the lesion and whether complicated with chordae rupture. All patients were treated with median incision and surgery under cardiopulmonary bypass. During the operation, mitral valve wedge resection, rectangular resection and edge-to-edge suture were used to repair the mitral valve, and the e-PTFE thread artificial tendon was used to repair rupture or lengthy of the chordae. The mitral valve forming ring was implanted routinely, and water was injected during the operation to observe and evaluate the effect of valve formation. By intraoperative mitral valvuloplasty, 7 cases (25.0%) were implanted with 1 to 3 chordae, 9 cases (32.1%) underwent mitral valve rectangular resection, and 8 cases (28.6%) underwent mitral valve wedge resection, 4 cases (14.3%) of mitral valve edge-to-edge suture, and all patients were implanted with saddle-shaped mitral annuloplasty ring. Patients combined with atrial fibrillation underwent simple left atrial appendage resection (LAA) or atrial fibrillation radiofrequency ablation (AB) plus LAA at the same time; for coronary heart disease, coronary artery bypass surgery (CABG) combined with moderate or above for tricuspid regurgitation, tricuspid annuloplasty (TVP) was performed at the same time. 1 patient (3.6%) underwent MVP+ CABG, 1 patient (3.6%) underwent MVP+ TVP+ LAA, 3 patients (10.7%) underwent MVP+ TVP+ AB+ LAA, 5 patients (17.9%) underwent MVP+ TVP, and 18 cases (64.3%) underwent simple MVP. Warfarin was treated with anticoagulation for 3 to 6 months after operation, and patients with atrial fibrillation were treated with lifelong anticoagulation. Statistics of all patients’ surgical methods were conducted, including combined surgical types, mitral valvuloplasty methods, comparison of patients’ regurgitation, cardiac function improvement and differences in LAD, LVEDD, and LVEF before and 2 years after surgery.

All patients had moderate and severe regurgitation before operation. Two years after operation, echocardiography showed that 21 cases (75.0%) had no obvious mitral regurgitation, 6 cases (21.4%) had mild mitral regurgitation, and 1 case (3.6%) had moderate mitral regurgitation. The cardiac function of all patients was improved by 1-2 grades. The preoperative LAD [(49.42±12.58) mm], 2-year LAD [(38.17±9.84) mm], preoperative LVEDD [(50.91±7.93) mm], postoperative LVEDD [(44.37±7.42) mm], postoperative; preoperative LVEF (51.69±9.71)% , postoperative LVEF(62.79 ± 8.53)%, LVEF increased significantly after operation.

MVP treatment of MR is safe and effective, but the long-term effect needs further study and follow-up.