title: A novel and simple technique for correction of posterior leaflet prolapse due to chordal elongation or rupture.
abstract: OBJECTIVE
  The study objective was to evaluate the midterm results of a technique for correction of posterior leaflet prolapse without resection or use of artificial chordae.
  
  
  METHODS
  From May 2009 to October 2013, 96 patients with isolated posterior leaflet prolapse (n=36) or bileaflet prolapse (n=60) with or without chordal rupture underwent posterior leaflet repair at the Prince Sultan Cardiac Center. The novel Uniscallop ("U") technique was used in 46 patients (group U), based only on scallop suture without resection or artificial chordae application. A conventional approach (quadrangular or triangular resection, focal sliding, artificial chordae) was adopted in the remaining 50 patients (group C). In both groups, the annulus was reshaped using a 40- or 50-mm-long band. Postoperative echocardiography was performed in all patients after a mean follow-up of 18±13 months in group U and 20±9 months in group C.
  
  
  RESULTS
  There were no early or late deaths. No patients in either group showed systolic anterior motion. Both surgical strategies were successful in obtaining a significant reduction in mitral regurgitation grade. Left ventricular function was maintained, and tricuspid regurgitation grade was reduced overall. Moderate mitral regurgitation during follow-up developed in only 1 patient in group C, as the result of dehiscence of a plication stitch.
  
  
  CONCLUSIONS
  Although the rationale for the use of the U technique is different from what is generally accepted, the midterm results of this approach are comparable to those obtained with more conventional techniques, remaining stable after a mean follow-up of 18 months.
authors.affiliation: Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. Electronic address: am.calafiore@gmail.com.
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Calafiore
authors.affiliation: Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Iacò
authors.affiliation: Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
authors.forename: Adam
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
authors.forename: Hussein
authors.initials: H
authors.lastname: Al-Amri
authors.affiliation: Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia; Department of Cardiothoracic Surgery, Mansoura University, Mansoura, Egypt.
authors.forename: Reda
authors.initials: R
authors.lastname: Refaie
authors.affiliation: Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
authors.forename: Ali
authors.initials: A
authors.lastname: Own
authors.affiliation: Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
authors.forename: El Shurafa
authors.initials: el S
authors.lastname: Heytham
authors.affiliation: Institute of Cardiology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Di Mauro
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002815:Chordae Tendineae / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000601:surgery*; D012421:Rupture; D056346:Sternotomy; D013536:Suture Techniques; D016896:Treatment Outcome