title: Posterior mitral leaflet repair with a simple segmental annulus support: the 'double-Teflon technique'.
abstract: 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.
authors: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors: Pablo M A
authors: PM
authors: Pomerantzeff
authors: Carlos M A
authors: CM
authors: Brandão
authors: Luciano R
authors: LR
authors: Souza
authors: Marcelo L C
authors: ML
authors: Vieira
authors: Max
authors: M
authors: Grimberg
authors: José A F
authors: JA
authors: Ramires
authors: Sérgio A
authors: SA
authors: Oliveira
mesh_terms: 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
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene