178-IRECONSTRUCTIVE SURGERY IN ADULTS WITH CONGENITAL MITRAL VALVE DISEASE

Objectives: Congenital mitral valve regurgitation is mostly seen in infants and it only represents 2% of all adult patients undergoing mitral valve surgery. The rarity of the disease in the adult patient and the complexity of the lesions often lead to misdiagnosis and subsequent mitral valve replacement. However, mitral valve repair might be feasible in most cases with durable long-term outcomes. Methods: Four different cases of severe mitral regurgitation in adult patients with congenital mitral valve disease are demonstrated in this video. From least complex to most complex, the lesions encountered included an abnormal atrial chordal attachment leading to anterior leaflet prolapse, abnormal papillary muscles (hammock valve), secundum atrial septal defect associated to severe bileaflet prolapse, and a partial atrioventricular canal in a patient with Barlow's disease. Results: Successful mitral repair was performed in all cases using a lesion-specific approach and blending techniques including the wide use of glutaraldehyde-fixed autologous pericardium. Conclusion: Mitral valve repair seems technically feasible in many adult patients with congenital mitral valve regurgitation.