[Mitral valve reconstruction: classic concepts for new indications].

Mitral valve reconstructive surgery has been established as the treatment of choice in patients with favourable anatomy. Long-term follow-up has shown a better survival, lower incidence of thromboembolism, endocarditis, neurological events, lower need for mitral valve-related reoperation, and a better ventricular function after valve repair than replacement. Subvalvular apparatus repair with chordae tendineae replacement with politetrafluoretilene suture and, more recently, using mitral valve homograft has widened the indications for valve reconstruction in some patients. The classic concepts of mitral annuloplasty are now used in new indications, as for the ischemic mitral regurgitation or the functional mitral insufficiency associated to dilated cardiomyopathy. The understanding of the patho-physiology of these entities has allowed these new surgical alternatives for valve repair.