title: Initial results of posterior leaflet extension for severe type IIIb ischemic mitral regurgitation.
abstract: 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.
authors.affiliation: McGill University Health Center, Montreal, Quebec, Canada. benoit.devarennes@muhc.mcgill.ca
authors.forename: Benoit
authors.initials: B
authors.lastname: de Varennes
authors.forename: Rakesh
authors.initials: R
authors.lastname: Chaturvedi
authors.forename: Surita
authors.initials: S
authors.lastname: Sidhu
authors.forename: Annie V
authors.initials: AV
authors.lastname: Côté
authors.forename: William Li Pi
authors.initials: WL
authors.lastname: Shan
authors.forename: Caroline
authors.initials: C
authors.lastname: Goyer
authors.forename: Roupen
authors.initials: R
authors.lastname: Hatzakorzian
authors.forename: Jean
authors.initials: J
authors.lastname: Buithieu
authors.forename: Allan
authors.initials: A
authors.lastname: Sniderman
mesh_terms: 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