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- Title
Posterior mitral annuloplasty for enhancing mitral leaflet coaptation: using a strip designed for placement in the posterior annulus.
- Authors
Jong Hun Kim; Kyung Hwa Kim; Jong Bum Choi; Ja Hong Kuh; Kim, Jong Hun; Kim, Kyung Hwa; Choi, Jong Bum; Kuh, Ja Hong
- Abstract
<bold>Background: </bold>In patients with mitral valve regurgitation (MR), posterior mitral annuloplasty (PMA) was performed for mitral valve repair using a strip designed for placement in the posterior annulus, sparing the anterior annulus and anterior half of the commissures.<bold>Methods: </bold>Between September 2009 and October 2013, we performed PMA using a novel strip in 74 consecutive patients with MR greater than 3+. Procedures associated with mitral valve repairs were performed in 41 patients (56.9 %), including new chord placement for leaflet prolapse (n=30), patch valvuloplasty for posterior chord rupture (n=4), and posterior leaflet augmentation (n=15). All patients were analyzed by serial echocardiographic follow-up, and preoperative and postoperative computed tomography was performed in 10 randomly selected patients.<bold>Results: </bold>Hospital death occurred in two patients (2.7 %), and 72 survived patients were completely followed up. At a mean follow-up of 37.2 ± 15.0 months, the MR grade was zero or 1+ in 64 patients (88.9 %), 2+ in 7 patients (9.7 %), and 3+ in one patient (1.4 %). The mean indexed valve area and mean valve gradient were 1.7 ± 0.4 cm(2)/m(2) and 3.5 ± 1.2 mmHg, respectively. The mean leaflet coaptation height in early systole was 12.8 ± 3.5 mm. During the cardiac cycle, the repaired valves exhibited dynamic changes of 19.5 ± 9.3 % in the septo-lateral dimensions. No early conversions to valve replacements or late reoperations occurred. None of the patients with remnant or recurrent MR experienced hemolysis.<bold>Conclusions: </bold>PMA using a novel strip showed a sufficient coaptation height secondary to reduction of the septo-lateral annular dimensions and dynamic changes in the dimensions. It can be expected to be an alternative mitral annuloplasty technique with satisfactory results.
- Subjects
MITRAL valve surgery; ECHOCARDIOGRAPHY; MITRAL valve insufficiency
- Publication
Journal of Cardiothoracic Surgery, 2015, Vol 10, p1
- ISSN
1749-8090
- Publication type
journal article
- DOI
10.1186/s13019-015-0350-6