title: Influence of involvement of anterior leaflet versus posterior leaflet on residual regurgitation as assessed by transesophageal echocardiography in patients undergoing valve repair for mitral regurgitation due to mitral valve prolapse.
abstract: BACKGROUND
  Repair of anterior leaflet prolapse is technically more challenging and this might influence outcomes as compared to the repair of posterior leaflet prolapse in patients undergoing surgical correction of mitral regurgitation. We investigated the association of anterior leaflet prolapse with minor residual mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) who underwent valve repair.
  
  
  METHODS
  Eligible for this study were consecutive patients with severe MR due to MVP, who underwent mitral valve repair with residual MR by postpump transesophageal echocardiography <or=2+ during a 20-month period at Pasquinucci Hospital, Massa. Patients undergoing other cardiovascular surgical interventions were excluded. Two groups were defined according to the involvement of mitral valve leaflets: group 1, consisting of patients with anterior leaflet prolapse (isolated or not); and group 2, consisting of patients with isolated posterior leaflet prolapse.
  
  
  RESULTS
  A total of 70 patients (18 in group 1 and 52 in group 2) were analyzed. Patients in group 2 were younger than those in group 1, but the difference was not significant (P = 0.052). There were no significant differences between the 2 study groups with respect to other variables. The proportion of patients with residual MR 1+/2+ was higher in group 1 than in group 2 (61.1% vs. 32.7%, respectively; P = 0.034). In a logistic regression model, anterior leaflet prolapse was an independent predictor of residual MR 1+/2+ (odds ratio, 4.0; 95% confidence interval, 1.14 to 14.04; P = 0.03).
  
  
  CONCLUSIONS
  In our study population, patients with anterior leaflet prolapse had a higher proportion of residual MR 1+/2+ as compared to those with posterior leaflet prolapse after repair of mitral valve.
authors.affiliation: G Monasterio Foundation, CNR-Regione Toscana, Institute of Clinical Physiology, G Pasquinucci Hospital, Massa, Italy. lauretasulcaj@yahoo.com
authors.forename: Laureta
authors.initials: L
authors.lastname: Sulcaj
authors.forename: Antonio
authors.initials: A
authors.lastname: Rizza
authors.forename: Mattia
authors.initials: M
authors.lastname: Glauber
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trianni
authors.forename: Cataldo
authors.initials: C
authors.lastname: Palmieri
authors.forename: Marcello
authors.initials: M
authors.lastname: Ravani
authors.forename: Alban
authors.initials: A
authors.lastname: Dibra
authors.forename: Stefano
authors.initials: S
authors.lastname: Maffei
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
mesh_terms: D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*