Mitral valve degeneration represents a huge proportion of the mitral regurgitation population, second only to rheumatic changes, and the former has become the treatment of choice for patients with mitral valve degeneration among the options of mitral valvuloplasty and valve replacement. It is well known that mitral valvuloplasty is inevitably followed by the risk of valvular failure and reoperation. Some patients have a high incidence of cardiovascular events after valvuloplasty (especially in the early stages), leaving them open to the possibility of reoperation or hospitalization. This not only places a severe psychological burden on patients who have just experienced the trauma of surgery, but also puts physicians under extreme stress. The aim of this paper is to do an analysis of the preoperative factors affecting the early prognosis of such patients through a retrospective study. 1. Data and Methods Clinical Data From January 2011 to November 2011, 132 patients with degenerative mitral insufficiency and mitral valvuloplasty were admitted to Fu Wai Cardiovascular Hospital, of whom 66 had preoperative ultrasound suggestive of atrial fibrillation due to combined tricuspid regurgitation of moderate degree or higher and 25 had preoperative electrocardiogram diagnosis. The exclusion criteria were as follows: (1) combined coronary artery bypass grafting, aortic valve replacement, and other combined cardiac surgery; (2) except for preoperative liver and kidney function and other organ dysfunction. Methods Patients routinely underwent cardiac ultrasound examination within 1 month before and 5 days after surgery. All enrolled patients underwent mitral valvuloplasty under hypothermic, extracorporeal circulation using a median sternal incision, with an intraoperative extracorporeal circulation time of 109.34±39.52 minutes and a block time of 77.69±28.83 minutes. All patients were followed up for a mean of 1.5 years after discharge using outpatient review and telephone return visits. Statistical treatment All data were expressed as mean ± standard deviation and statistically analyzed using SPSS software package. p<0.05 was considered statistically different. 2. Results A total of 114 patients (86.4%) were followed up in this study. 2 patients died during follow-up, 2 patients underwent mitral valve replacement or plication again, and 15 patients had a review suggestive of mitral regurgitation of moderate amount or above. 3, Discussion Currently, there are many studies on the risk factors for long-term prognosis after mitral valvuloplasty, and most results have demonstrated the advantages of valvuloplasty over valve replacement. With the improvement of surgical techniques and the development of valve materials, studies have also confirmed that no significant differences have been seen in the living status and survival rate of patients in the early postoperative period after valve replacement and valvuloplasty. Therefore, if patients are at high risk for cardiovascular events early after valvuloplasty, their expectation of benefit from valvuloplasty is greatly diminished, and early valve replacement may be a better option for these patients. In this study, a significant difference in preoperative left ventricular end-diastolic internal diameter was found between the two groups, and the preoperative dilated left ventricle was considered a risk factor for reoperation. Whereas the cause has not been satisfactorily explained, we believe that a long and severe chronic regurgitant bundle produces adverse stimulation of the mitral leaflets, and when regurgitation is aggravated, leaflet damage is more severe, which eventually leads to progression of degenerative left ventricular changes, left ventricular enlargement, and consequently, overall systolic performance. This is likely to continue to progress after the regurgitant factors are relieved in the late stage of the lesion and will seriously affect the early prognosis of mitral valvuloplasty. In this study, we also found that changes in left ventricular internal diameter before and after surgery may have an impact on the prognosis of surgery, and there is no better index to assess the cardiac morphology of patients before and after surgery, we tried to assess the change in cardiac morphology by the ratio of the amount of change in left ventricular internal diameter to the preoperative left ventricle. By multifactorial analysis, the greater the value of alteration (generally narrowing) at a certain intraventricular diameter of the left ventricle (larger, i.e., preoperative left ventricular dilatation), the greater the rate of early postoperative events could be reduced. Since all postoperative patients have little or less regurgitation, it can basically be assumed that this value represents the natural state of the heart after morphologic changes due to excessive preload caused by exclusion of regurgitation. In patients with excessive preoperative left ventricular diameter, it is possible for it to normalize after the factors influencing the regurgitation are removed, indicating either increased myocardial contractility or decreased preload, or both. If the change is not significant, it indicates that the heart is already dilated in its natural form and function has been compromised to varying degrees. As a retrospective study, this study needs to expand the sample size for analysis; and for the prediction of the degree of postoperative left ventricular diameter alteration, we are continuing to follow up relevant cases and refine the next study. 4. Conclusion In patients with degenerative mitral regurgitation who are proposed for mitral valvuloplasty, the incidence of early postoperative cardiovascular events is higher in patients with a larger preoperative left ventricle, whereas in such patients, the incidence of postoperative events is significantly lower in those with a significantly smaller left ventricular diameter.