title: Preservation of Mobility of the Posterior Mitral Leaflet After Mitral Valve Repair With Neochordae Using Loop Technique.
abstract: BACKGROUND
  Recently, the loop technique has been standardized for mitral valve repair, with excellent long-term outcomes reported. This study thus analyzed whether the loop technique could preserve mitral leaflet mobility on trans-thoracic echocardiography.
  
  
  RESULTS
  Among 367 concomitant patients who underwent mitral valve repair at Keio University Hospital between January 2007 and December 2014, 304 patients had a prolapse of the posterior leaflet. Of these, 84 cases assessed on echocardiography were retrospectively analyzed for this study. These patients were divided into 4 groups based on the procedure used: (1) group L1 (n=28), loop technique alone; (2) group L2 (n=14), loop technique with resection and suture; (3) group L3 (n=33), loop technique with plication of indentation; and (4) group R (n=9), resection and suture alone. The mean postoperative mobile posterior mitral leaflet (PML) angles in groups L1 and L2 (39.3±16.0°, 37.3±16.0°) were significantly larger than those in groups L3 and R (18.8±15.7°, 15.3±15.7°), respectively (P<0.01). Ring size, age, and mobile PML angle had a statistically significant correlation with the postoperative mean mitral valve pressure gradient (P<0.05).
  
  
  CONCLUSIONS
  The loop technique preserved PML mobility and enabled implantation of a larger ring, resulting in a reduced mean mitral valve pressure gradient. (Circ J 2016; 80: 663-667).
authors.affiliation: Department of Cardiovascular Surgery, Keio University, School of Medicine.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kitahara
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Murata
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Mikihiko
authors.initials: M
authors.lastname: Kudo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshitake
authors.forename: Hikaru
authors.initials: H
authors.lastname: Tsuruta
authors.forename: Yuji
authors.initials: Y
authors.lastname: Itabashi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yozu
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*