title: Local suture annuloplasty for posterior mitral valve repair: 18-year experience.
abstract: We retrospectively reviewed 128 consecutive patients who underwent quadrangular resection of a prolapsed posterior mitral leaflet and local suture annuloplasty. The median age was 68.1 ± 10.0 years (range, 30-84 years) and 63.3% were male. Mean left ventricular ejection fraction was 63.8% ± 10.2% (range, 25%-80%). The etiology of mitral regurgitation was fibroelastic degeneration in 94 (73.4%) patients, myxomatous degeneration in 26 (20.3%), myxomatous infective endocarditis in 7 (5.5%), and post-infarction papillary rupture in one. There was 1 (0.8%) hospital death. The median follow-up was 4.7 ± 4.7 years (range, 0.01-18.29 years). The freedom from reoperation was 98%, 94%, 87%, and 79% at 1, 5, 10, and 15 years, respectively, improving for the most recent 107 patients, subsequent to technical modification, to: 100%, 96%, 94%, and 90% at 1, 5, 10, and 14 years, respectively. Ten- and 15-year freedom from severe mitral regurgitation was 91%, and 88%, respectively. The overall actuarial 1-, 5-, 10-, and 15-year survival rates were 98%, 90%, 70%, and 52%, respectively, similar to that of the age- and sex-matched United Kingdom population. The long-term results of this technique in selected patients with prolapsed posterior leaflet were considered acceptable.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, HospitalUniversity of Tours, Headley Way, Tours, France.Ravi.Pillai@nds.ox.ac.uk
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Soon
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.forename: Brian
authors.initials: B
authors.lastname: Shine
authors.forename: Xu-Yu
authors.initials: XY
authors.lastname: Jin
authors.forename: Shirley
authors.initials: S
authors.lastname: Janas
authors.forename: Ravi
authors.initials: R
authors.lastname: Pillai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004739:England; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000401:mortality; D008945:Mitral Valve Prolapse / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013536:Suture Techniques / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome