Results of a technique of mitral valve repair

Repair of the anterior mitral leaflet

BACKGROUND

Repair rather than replacement of the diseased mitral valve has been the goal of the cardiac surgeon. Although well accepted for posterior leaflet pathology, a diseased anterior leaflet was believed by some to be irreparable.

AIMS

To assess the result of reconstructive mitral valve surgery involving the anterior mitral leaflet in a selected group of patients.

METHODS

Twenty consecutive patients with degenerative (19), ischaemic (one) and congenital/calcific mitral regurgitation were evaluated. There were five females and 15 males with a mean age of 62 +/- 12 years (41-75 years). The technique used to repair these valves included chordal transposition, leaflet plication commissuroplasty and a new technique we call leaflet repositioning.

RESULT

There were no deaths, follow-up is complete with mean follow-up of 31 +/- five months (two-102) months. All patients have had 2DE and 13 TOE as well. There have been no reoperations due to failure of the repair, 95% of patients are in NYHA Class I-II post operative, while 15% have significant residual regurgitation.

Repairing the degenerative anterior mitral leaflet

This is a consecutive, nonselected series of 18 patients with degenerative mitral regurgitation requiring a reparative operation on the anterior mitral leaflet. A new technique of double-breasting the two leaflets when flail septal segments are encountered is introduced.