title: Mitral valve repair. Quadrangular resection of the posterior leaflet in patients with myxomatous degeneration.
abstract: OBJECTIVE - To analyze the immediate and late results of mitral valve repair with quadrangular resection of the posterior leaflet without the use of a prosthetic ring annuloplasty. METHODS - Using this technique, 118 patients with mitral valve prolapse who underwent mitral repair from January '84 through December '96 were studied. Age ranged from 30 to 86 (mean = 59.1+/-11.8) years and 62.7% were males. An associated surgery was performed in 22% of the patients, and coronary artery bypass graft was the most frequently performed surgery (15 patients - 12.7%). In 20 (16.9%) patients other associated techniques of mitral valve repair were used and shortening of elongated chordae tendineae was the most frequent one (6 patients). RESULTS - Immediate mortality was 0.9% (one patient). Long-term rates for thromboembolism, endocarditis, re-operation and death in the late postoperative period were 0.4%, 0.4%, 1.7% and 2.2% patients/year, respectively. The actuarial curve of survival was 83.8+/-8.6% over 12 years; survival free from re-operation was 91.8+/-4.3%, free from endocarditis was 99.2+/-0.8% and free from thromboembolism was 99.2+/-0.8%. In the late postoperative period, 93.8% of the patients were in functional class 1 (NYHA), with a complete follow-up in 89.7% of the patients. CONCLUSION - Patients with mitral valve prolapse who undergo mitral valve repair using this technique have a satisfactory prognosis over 12 years.
authors.affiliation: Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil.
authors.initials: PM
authors.lastname: Pomerantzeff
authors.initials: CM
authors.lastname: Brandão
authors.initials: EG
authors.lastname: Rossi
authors.initials: LF
authors.lastname: Cardoso
authors.initials: F
authors.lastname: Tarasoutchi
authors.initials: M
authors.lastname: Grinberg
authors.initials: NA
authors.lastname: Stolf
authors.initials: LB
authors.lastname: Puig
authors.initials: G
authors.lastname: Verginelli
authors.initials: AD
authors.lastname: Jatene