Initial results of posterior leaflet extension for severe type IIIb ischemic mitral regurgitation.
BACKGROUND
Management of severe ischemic mitral regurgitation remains difficult with disappointing early and intermediate-term surgical results of valve repair.


RESULTS
Forty-four patients with severe (4+) Carpentier type IIIb ischemic mitral regurgitation underwent mitral valve repair, with or without surgical revascularization, by posterior leaflet extension with a patch of bovine pericardium and a remodeling annuloplasty. Serial echocardiography was performed preoperatively, intraoperatively, and postoperatively to assess mitral valve competence. The postoperative functional status of patients was assessed. The average Parsonnet score was 38+/-13. Thirty-day mortality was 11%, and late mortality was 14%. Mean follow-up was 38 months. The actuarial freedom from moderate or severe recurrent mitral regurgitation was 90% at 2 years, whereas 90% of patients were in New York Heart Association class I at 2 years.


CONCLUSIONS
Posterior leaflet extension with annuloplasty of the mitral valve for severe type IIIb ischemic regurgitation is a safe, effective method that provides good early and intermediate-term competence of the mitral valve and therefore good functional status.
de Varennes
Benoit
B
McGill University Health Center, Montreal, Quebec, Canada. benoit.devarennes@muhc.mcgill.ca
Chaturvedi
Rakesh
R
Sidhu
Surita
S
Côté
Annie V
AV
Shan
William Li Pi
WL
Goyer
Caroline
C
Hatzakorzian
Roupen
R
Buithieu
Jean
J
Sniderman
Allan
A
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery* / Q000648:ultrastructure; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D009203:Myocardial Infarction / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery; D016277:Ventricular Function, Left