The Open Correction of Rheumatic Mitral Regurgitation and/or Stenosis

Progressive Reinvention or Destination Lost? Half a Century of Cardiovascular Tissue Engineering

“…A decade later, replacement heart valves were at a junction. Although repairing the mitral valve was already described in the late 1950s ( 43 – 45 ) and the aortic valve in the early 1960s ( 46 – 48 ) repair-techniques took a back seat for decades to the easily reproducible insertion of a prosthetic device. Disappointingly, the long-term performance of these replacement valves was sub-optimal, either due to complications with anticoagulation in mechanical valves or the fast degeneration of tissue valves in young and middle-aged patients.…”

Surgical Correction of Mitral Incompetence Resulting From Bacterial Endocarditis

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The surgical correction of mitral incompetence by internal reconstruction of the valve ring and the cusps has proved disappointing (Effier et al, 1958;Merendino et al, 1959) and has been followed by attempts at partial or total valve replacement (Braunwald, Cooper, and Morrow, 1960). While our experience with internal reconstructive procedures in patients with severe rheumatic mitral incompetence, with or without some degree of stenosis, has also proved unsatisfactory with a failure rate of about 50 per cent, more encouraging results have been obtained in patients with mitral incompetence following bacterial endocarditis.

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