Association between residual mitral regurgitation and left ventricular outflow obstruction after Carpentier ring mitral annuloplasty

Midterm outcome of leaflet folding plasty for mitral regurgitation due to posterior leaflet prolapse

OBJECTIVE

Leaflet folding plasty was introduced as an effective technique to avoid systolic anterior motion (SAM) after mitral valve repair. The purpose of this study was to investigate the midterm outcome of leaflet folding plasty following a review of our 10-year experience.

METHODS

Between October 1997 and May 2008, a total of 45 patients with mitral valve regurgitation due to posterior leaflet prolapse were operated on using leaflet folding plasty (63% of posterior leaflet repair and 28% of overall mitral valve repair during the same period). The group comprised 29 men and 16 women, with a mean age of 63.2 years. There were 44 patients with degenerative valve disease and 1 with healed infective endocarditis. The prolapsed scallop were P1 in 1, P2 in 33, and P3 in 11 patients. Anterior mitral leaflet involvement was seen in two patients.

RESULTS

Mitral valve repair was performed in all patients. SAM with residual mitral regurgitation was observed in two patients, with one requiring intraoperative revision. The 30-day mortality was 2.2% (one patient died from intestinal complications). The mean follow-up period for survivors was 38.1 months (range 1-127 months). The 1- and 5-year actuarial survival rates were 97.8% and 93.7%, respectively. None of the patients required reoperation during follow-up.

CONCLUSION

Midterm outcome of leaflet folding plasty for mitral valve repair was satisfactory. This technique accomplishes mitral valve repair safely in patients with mitral regurgitation due to posterior prolapse, with acceptable intermediate-term freedom from reintervention.