ANESTHESIOLOGISTS cannot concentrate solely on advances made within the specialty,
but must also keep up with developments occurring within the field of surgery because
the surgical management of the patients partly determines the anesthetic management.
Mitral valve disease and its surgical therapy represent a very dynamic area within
the field of cardiac surgery. Thanks to better understanding of the anatomy of the
mitral valve apparatus, pathophysiology of underlying disease processes, and improvements
in surgical technique, a shift has taken place clearly favoring mitral valve repair
over mitral valve replacement for regurgitant lesions.
1
,
2
Despite this shift in surgical philosophy, as reflected in the 2006 guidelines published
by the American Heart Association/American College of Cardiology (AHA/ACC), repair
rates for mitral valve regurgitation continue to languish around 50% in the United
States and Europe,
3
,
4
even though numerous reports have shown that mitral valve repair is durable and has
superior long-term survival rates when compared with mitral valve replacement.
5
,
6
,
7
,
8
Key words
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Article info
Footnotes
William C. Oliver, Jr, MD
Paul G. Barash, MD
Section Editors
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
