Valve repair for mitral regurgitation caused by isolated prolapse of the posterior leaflet.
BACKGROUND
Although prolapse of the posterior leaflet is the most common abnormality of the mitral valve causing dysfunction, the long-term results of mitral valve repair for this condition are seldom reported.


METHODS
From October 1988 to June 1994, 208 patients (mean age, 59.4 years) with mitral regurgitation caused by isolated prolapse of the posterior leaflet underwent mitral valve repair alone or combined with myocardial revascularization (n = 30). The surgical techniques were quadrangular resection (n = 199) followed by annulus plication (n = 101) or sliding leaflet plasty (n = 98), use of artificial chordae (n = 5), or papillary muscle shortening (n = 4). All patients had an annuloplasty with a Carpentier ring. Mean follow-up was 3.4 +/- 0.1 years and total follow-up, 656 patient-years.


RESULTS
There were six operative deaths (2.9%). Postoperative Doppler echocardiography found two cases of systolic anterior motion (1%), and echocardiographic studies at follow-up showed satisfactory mitral valve function in 97% of 112 patients. At 6 years, the actuarial survival rate was 87% +/- 7%, and freedom from thromboembolic complications, bleeding complications, and reoperation was 93% +/- 7%, 95% +/- 3%, and 95% +/- 4%, respectively.


CONCLUSIONS
Mitral valve repair for regurgitation caused by prolapse of the posterior leaflet provides excellent survival at 6 years and should be considered the method of choice for its surgical treatment.
Perier
P
P
Herz und Gefäss Klinik, Bad Neustadt/Saale, Germany.
Stumpf
J
J
Götz
C
C
Lakew
F
F
Schneider
A
A
Clausnizer
B
B
Hacker
R
R
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality; D018572:Disease-Free Survival; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000150:complications*; D011183:Postoperative Complications; D012086:Reoperation; D013923:Thromboembolism / Q000209:etiology