Reconstructive procedures in heart valve disease.

The percentage of patients who undergo valve repair has increased considerably during the past decade. Valve repair is particularly important in patients with atrioventricular valve disease since it provides better results than replacement. Aortic valve repair is presently performed only in selected patients with aortic stenosis and insufficiency. There is a renewed interest in aortic valve debridement in patients with calcific aortic stenosis. Mitral valve repair can be performed in most patients with mitral insufficiency and in many with mitral stenosis. The surgical techniques for mitral valve repair are well established and are reproducible. The tricuspid valve is almost always reparable in patients with tricuspid disease associated with mitral valve disease.