The edge-to-edge technique as a trick to rescue an imperfect mitral valve repair.
OBJECTIVE
The edge-to-edge (E-to-E) technique in mitral valve repair (MVR) is promising especially to correct mitral insufficiency (MI) caused by complex mitral valve lesions. We tested this technique to improve residual MI straight after conventional MVR.


METHODS
From September 1998 to January 2002, 108 consecutive patients underwent MVR with current techniques for pure MI. Intraoperative transesophageal echocardiography was performed before and after MVR. At the end of cardiopulmonary bypass (CPB), 11 patients presented residual mitral regurgitant jet area (MRA) > or =2.0 cm(2). The E-to-E technique was used to improve this residual MI, without taking-down the original MVR.


RESULTS
There were no hospital deaths. One patient died of non-valve-related cardiac death about 6 months after hospital discharge. At intraoperative ecocardiography, residual MRA improved from 3.0 +/- 0.8 cm(2), after conventional MVR, to 0.7 +/- 0.9 cm(2), after the E-to-E technique (P = 0.00014). Additional CPB time of 14.9 +/- 2.8 min was needed. These echocardiographic results were confirmed at follow-up of 13.8 +/- 8.1 months.


CONCLUSIONS
The E-to-E technique is a simple, rapid, effective, and durable option to reduce residual MI and rescue an imperfect conventional MVR.
Gatti
Giuseppe
G
Department of Cardiac Surgery, Villa Torri Hospital, viale Filopanti, 12 - 40126 Bologna, Italy. giusep.gatti@tiscali.it
Cardu
Gabriele
G
Trane
Rosanna
R
Pugliese
Peppino
P
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure