title: Early and follow-up results of butterfly resection of prolapsed posterior leaflet in 76 consecutive patients.
abstract: OBJECTIVE
  The present study aims to examine the medium-term results of butterfly resection.
  
  
  METHODS
  Of 587 consecutive patients who underwent surgery for mitral regurgitation between January 2002 and August 2012, 162 patients underwent valve reconstruction of a prolapsed posterior leaflet. Quadrangular resection (n = 50, Quadrangular group) was primarily used before November 2006 (when we innovated the concept of butterfly resection). After that, we mainly used butterfly resection (n = 76, Butterfly group).
  
  
  RESULTS
  Although there was no sign of systolic anterior motion in the Butterfly group, it occurred in 2 patients in the Quadrangular group. One patient in the Quadrangular group died of stroke at postoperative day 17. The mean follow-up period was 2.2 ± 1.6 years for the Butterfly group and 6.1 ± 2.5 years for the Quadrangular group. During those periods, 2 patients died of noncardiac causes in the Butterfly group and 1 patient died of an unknown cause in the Quadrangular group. One patient in the Quadrangular group required a reoperation for recurrent mitral regurgitation arising from a new lesion of the anterior leaflet. One patient in the Butterfly group required a reoperation for partial dehiscence of suture at the posterior leaflet. The 3-year estimated survivals free from overall death and reoperation for recurrent mitral regurgitation in the Butterfly group and the Quadrangular group were 97% ± 2% versus 96% ± 3% (P = .89) and 95% ± 3% versus 96% ± 3% (P = .75), respectively.
  
  
  CONCLUSIONS
  Butterfly resection provides acceptable early and medium-term results.
authors: Division of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Japan. Electronic address: toruasai@belle.shiga-med.ac.jp.
authors: Tohru
authors: T
authors: Asai
authors: Division of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Japan.
authors: Takeshi
authors: T
authors: Kinoshita
authors: Division of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Japan.
authors: Tomoaki
authors: T
authors: Suzuki
authors: Division of Cardiovascular Surgery, Oumikusatsu Tokusyukai Hospital, Kusatsu, Shiga, Japan.
authors: Shoichiro
authors: S
authors: Shiraishi
authors: Division of Cardiovascular Surgery, Oumikusatsu Tokusyukai Hospital, Kusatsu, Shiga, Japan.
authors: Masato
authors: M
authors: Koike
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome