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Comparative Study
. 2016;22(1):32-7.
doi: 10.5761/atcs.oa.15-00153. Epub 2015 Aug 28.

Midterm Outcome of Mitral Valve Repair with Artificial Chordae for Only Posterior Leaflet Disease-Comparison with the Resectional Technique in a Single Institute

Hideaki Takai  1 , Hiroaki Tanabe, Tsuyoshi Yamabe, Kenichi Sasaki, Hisayoshi Suma
Affiliations
Comparative Study

Midterm Outcome of Mitral Valve Repair with Artificial Chordae for Only Posterior Leaflet Disease-Comparison with the Resectional Technique in a Single Institute

Hideaki Takai et al. Ann Thorac Cardiovasc Surg. 2016.

Abstract

Objective: We compared the midterm results of mitral valve repair with and without leaflet resection, and revealed the effectiveness of this technique, even for in the posterior leaflet alone.

Patients: From August 2002 to March 2014, a total of 306 mitral valve repairs were carried out at our hospital. Of these patients, 50 cases did not undergo leaflet resection (Artificial Chordae; Group A) and 56 cases underwent leaflet resection (Resectional; Group R). There were no significant differences in the preoperative profiles.

Results: The follow up rate was 98% and 100% respectively. The mean cardiopulmonary bypass time and aortic cross clamp time were not significantly different. The average ring size was significantly larger (p <0.01) in Group A. All cause mortality at 3 years and 8 years was both 97.8% in Group A and was both 98.1% in Group R. Freedom from moderate mitral regurgitation at 3 years was 97.1% and at 8 years was 91.7% in Group A and 97.4% and 94.6% in Group R respectively. There were no cases of mortality, re-operation for recurrent mitral regurgitation, hemolytic anemia and infectious endocarditis.

Conclusion: We demonstrated good midterm results in mitral valve repair without leaflet resection. However, further follow-up was needed.

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Figures

Fig. 1
Fig. 1
All cause mortality; No signicant differences, At the 8-year follow up, all cause mortality was 97.8% and 98.1% in Group A and Group R, respectively (p = 0.87).
Fig. 2
Fig. 2
Freedom from moderate MR; No signify differences, At the 8-year follow up, freedom from moderate mitral regurgitation was 91.7% and 94.6% in Group A and Group R, respectively (p = 0.26). MR: mitral regurgitation
Fig. 3
Fig. 3
The findings of echocardiography, (A) diastolic phase after Resectional technique, (B) systolic phase after Resectional technique, (C) diastolic phase after RRR technique, (D) systolic phase after RRR technique. As shown in the figure, the posterior leaflet of mitral valve moves physiologically after RRR technique, however the posterior leaflet restrictively moves or hardly moves in Resectional technique. RRR: respect rather than resect
See this image and copyright information in PMC

References

    1. McGoon DC. Repair of mitral valve insufficiency due to ruptured chordae tendinae. J Thorac Cardiovasc Surg 1960; 39: 357-9.
    1. Carpentier A. Cardiac valve surgery–the “French correction”. J Thorac Cardiovasc Surg 1983; 86: 323-37. - PubMed
    1. David TE. Replacement of chordae tendineae with expanded polytetrafluoroethylene sutures. J Card Surg 1989; 4: 286-90. - PubMed
    1. Frater RW, Vetter HO, Zussa C, et al. Chordal replacement in mitral valve repair. Circulation 1990; 82(5 Suppl): IV125-30. - PubMed
    1. Lawrie GM, Earle EA, Earle NR. Feasibility and intermediate term outcome of repair of prolapsing anterior mitral leaflets with artificial chordal replacement in 152 patients. Ann Thorac Surg 2006; 81: 849-56; discussion 856. - PubMed

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