"Edge-to-edge" repair for anterior mitral leaflet prolapse.
The aim of this study is to report our results in a series of 150 consecutive patients (mean age 53 +/- 15.4 years) in whom mitral regurgitation (MR) due to isolated anterior mitral leaflet (AML) prolapse was corrected using the edge-to-edge (E to E) technique over a period of more than 10 years. At admission, 49 (32.6%) patients were in NYHA class I, 46 (30.6%) in II, 51 (34%) in III and 4 (2.6%) in IV. In the great majority of the cases (111 patients, 74%), degenerative disease was the cause of MR. Hospital mortality was 0.6% (1/150). There were 7 late deaths. The actuarial overall survival and freedom from reoperation at 9 years were 91.6% +/- 3.16% and 96.6% +/- 1.74%, respectively. At follow-up (4.5 +/- 3.21 years, range 2 months-12 years), the mean mitral valve area was 2.7 +/- 0.5 cm(2) and mitral regurgitation was absent or mild in 132 patients (88%). The results of this study demonstrate the effectiveness and durability of the E to E repair in the setting of AML prolapse. In our institution, this technique, in conjunction with annuloplasty, remains the method of choice to correct segmental prolapse of the AML.
Alfieri
Ottavio
O
Department of Cardiac Surgery, Vita e Salute University, Ospedale Universitario San Raffaele, Via Olgettina 60, 20132 Milan, Italy. ottavio.alfieri@hsr.it
De Bonis
Michele
M
Lapenna
Elisabetta
E
Regesta
Tommaso
T
Maisano
Francesco
F
Torracca
Lucia
L
La Canna
Giovanni
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome