Posterior mitral leaflet repair with a simple segmental annulus support: the 'double-Teflon technique'.
OBJECTIVE
The study aim was to present immediate and late results of a modified technique for mitral valve repair--the 'double-Teflon technique'. This consists of quadrangular resection of the posterior leaflet, annulus plication with 'pledgetted' stitches over a Teflon patch, and leaflet suture.


METHODS
Seventy-two patients (41 males, 31 females; mean age 60.5+/-11.9 years) with mitral insufficiency due to myxomatous degeneration and ruptured or elongated chordae tendineae underwent mitral valve repair with this technique. Fifteen patients (18%) had associated cardiovascular disease including coronary artery disease, aortic insufficiency, aortic stenosis and atrial septal defect. Operative, immediate postoperative and late operative echocardiographic data of the first 29 patients were analyzed. Actuarial survival was assessed using the Kaplan-Meier method.


RESULTS
There was one operative death (1%). By the late postoperative period, 95% of survivors were in NYHA functional class I. There were no episodes of hemolysis or endocarditis; the linearized rate for thromboembolism was 1.4%/patient-year. Actuarial survival at 72 months was 94.5+/-3.2%. Doppler echocardiography showed a significant decrease in mean left atrial diameter (p = 0.0001) and left ventricular diastolic diameter (p = 0.0003).


CONCLUSIONS
Mitral valve repair with the 'double-Teflon technique' is associated with low operative mortality, satisfactory survival rates, and good clinical outcome.
Pomerantzeff
Pablo M A
PM
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Brandão
Carlos M A
CM
Souza
Luciano R
LR
Vieira
Marcelo L C
ML
Grimberg
Max
M
Ramires
José A F
JA
Oliveira
Sérgio A
SA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000401:mortality / Q000601:surgery; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene