Rheumatic mitral valve repair: a personal perspective and results

Rheumatic mitral valve disease remains a challenge for cardiac surgeons. Valve repair has several advantages over valve replacement but is technically demanding for good results. To improve rheumatic mitral valve repair, surgeons need to have a deep understand of the mitral valve complex and its dynamics. The goal of repair is to restore normal diastolic and systolic function. The current approach is to perform a holistic repair of the entire mitral complex. Each part of the complex is thoroughly explored to define the problem. Several innovative techniques have been introduced to correct valve dysfunction and provide gratifying results. The details of these techniques will be described, based on an understanding of the relationship of the mitral valve complex and dynamics. With this approach, rheumatic mitral valve repair is becoming more successful, reproducible, and safe. Long-term follow-up is mandatory.