[Suture annuloplasty for mitral regurgitation with modified Paneth-Burr's method].
Plication of the leaflets or chordae reconstruction combined with annuloplasty cave been the standard procedure of the mitral valve repair for mitral regurgitation (MR). We have chosen the JH Kay's method for mitral annuloplasty. However, the long term results were not necessarily satisfactory because of various types of the mitral lesions. We have adopted the semicircular suture annuloplasty (Paneth-Burr's method) as the first choice for MR since May, 1991. In this paper, we demonstrate our modified operative procedure of the Paneth-Burr's method and the operative results. Also, to decide the optimal size of the annulus after annuloplasty, we evaluated the changes in size of the annulus and extent of mitral regurgitation before and about 16.3 months after surgery in 21 patients (pts) with MR undergoing Paneth-Burr's method, using Doppler echocardiography. On this annuloplasty, a double suture of EPTFE string (GORE-TEX) guarded with plegets was placed at the margin of the central fibrous body, sutured circumferentially around the annulus. Two rows of the suture were crossed in every several stitches to prevent cutting. A second suture was placed on the opposite side of the annulus in the same fashion. The MR patients were divided, by their size of the annulus after annuloplasty, into group A (less than 90% of normal annular diameter, 15 pts) and group B (more than 90% of normal annular diameter, 6 pts). In 14 of 15 pts of group A, mitral regurgitation was improved from grade 2-4 to grade 0-1 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
Shintani
H
H
First Department of Surgery, Osaka University Medical School, Japan.
Taniguchi
K
K
Nakano
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008722:Methods; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D013536:Suture Techniques