title: Edge-to-edge mitral valve repair for isolated prolapse of the anterior leaflet caused by degenerative disease.
abstract: OBJECTIVE
  The use of new techniques to correct mitral regurgitation due to prolapse of the anterior leaflet has been shown to expand the original surgical armamentarium and to improve postoperative outcome. We retrospectively analysed our experience with isolated prolapse of the anterior mitral leaflet repaired using the edge-to-edge technique.
  
  
  METHODS
  From October 1986 to June 2004, 790 patients underwent mitral valve repair for mitral regurgitation at our institution. Isolated pathology of the anterior mitral leaflet, due to degenerative disease, was the cause of mitral regurgitation in 84 patients and, from 1991, 68 underwent edge-to-edge repair.
  
  
  RESULTS
  There was no intraoperative death and one in-hospital death. Three patients died in the late follow-up period for a cumulative 13-year survival rate of 90 +/- 1.4%. No patient underwent early reoperation. Four patients underwent reoperation during the follow-up for a cumulative 13-year freedom from reoperation of 92.3 +/- 3.2%. At echocardiographic evaluation, mitral valve repair failure was associated with severe mitral regurgitation in four patients. Of the remaining 60 patients, 40 had no residual regurgitation, 18 had trivial residual regurgitation, and two had mild regurgitation. At follow-up, 49 patients are still in New York Heart Association (NYHA) class I, 14 in NYHA class II and only one in NYHA class III.
  
  
  CONCLUSIONS
  Our study demonstrates that the 'edge-to-edge' technique is a reliable procedure to correct prolapsing leaflets. The addition of this technique to the surgical armamentarium has neutralized prolapse of the anterior leaflet as an incremental risk factor for reoperation.
authors: Operative Unit of Cardiac Surgery, Brescia, Italy. carlofucci@libero.it
authors: Carlo
authors: C
authors: Fucci
authors: Giuseppe De
authors: GD
authors: Cicco
authors: Ermanna
authors: E
authors: Chiari
authors: Matilde
authors: M
authors: Nardi
authors: Pompilio
authors: P
authors: Faggiano
authors: Roberto
authors: R
authors: Procopio
authors: Giuseppe
authors: G
authors: Coletti
authors: Manfredo
authors: M
authors: Rambaldini
authors: Roberto
authors: R
authors: Lorusso
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008382:Marfan Syndrome / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome