Plastic surgery for cardiac valves: 15 years' experience.

We suggest that all patients with heart valve diseases should be considered for reconstructive plastic surgery, regardless of the numerous modern mechanical and biological prostheses available in a cardiac surgeon's arsenal. We have 15 years of experience, with 903 plastic surgical procedures with cardiopulmonary bypass for acquired mitral (636), aortic (51), and tricuspid (216) valve diseases. The 15-year survival rate for patients with mitral stenosis was 68% +/- 5%, and the 8-year survival rate for patients with mitral insufficiency was 81% +/- 3%. The 10-year survival rate for patients with mitral and tricuspid valve disease was 59% +/- 3% because of the initially grave condition of such patients. For the correction of acquired aortic valve disease we advocate a new type of operation: a method of stent plasty of the aortic root with two circular sutures placed on the level of the arch and fibrotic ring. In combination with gradual commissurotomy, parietal resection of leaflets and parocommissural plication are performed. This procedure is an effective method for the plastic reconstruction of the aortic valve, and it provides a good hemodynamic effect.