[Mitral valvular disease].

I reviewed the literature on surgical cases of the mitral valvular disease and picked out papers which offer beneficial data for informed consent on mitral valvular surgery. Japanese registries of thoracic cardiovascular surgery in current ten-years showed that the cases of mitral valvuloplasty (MVP) have gradually increased and those of mitral valve replacement (MVR) with mechanical valve prostheses have gradually decreased. The current guideline for indication of PTMC, the surgical indication of mitral regurgitation (MR) and the choice of the valve prosthesis are presented. The freedom from structural valve deterioration after MVR with bioprosthesis and valve related complications with mechanical valve prosthesis, derived from major reports, are demonstrated. The freedom from reoperation and recurrence of MR after MVP for posterior, anterior and both leaflets are demonstrated. Recently, the differences between Barlow disease and fibroelastic deficiency in MR have been focused. To assess the prognosis and morbidity after MVP for MR, several papers emphasized that not only the location of the prolapse lesion but the etiologic classification of the degenerative mitral valve disease is also important.