| Surgical repair of the prolapsing anterior leaflet in degenerative mitral valve disease. | |
| | |
MedLine Citation:
|
PMID: 10678378 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND AIM OF THE STUDY: Repair of the prolapsing anterior leaflet (AML) in degenerative mitral valve disease is more demanding than that of the posterior leaflet. We reviewed our experience in the past eight years, to examine the safety, efficacy and stability of various repair artifices. METHODS: Between January 1989 and December 1997, 102 patients (mean age 64 years; range: 26-86 years) with mitral regurgitation (MR) due to prolapse of the anterior or both mitral leaflets underwent mitral valve repair. Sixty-six patients were in NYHA class > or =III, and 94 had MR grade >II. Acute endocarditis was present in 12 patients and Barlow disease in 16. Surgical techniques consisted of chordal shortening (n = 36), chordal transposition (n = 16), papillary muscle shortening or plication (n = 10), flip-over (n = 20) and artificial chordae implantation (n = 20). RESULTS: There was no early mortality; one patient required early mitral valve replacement (MVR) for late-appearing systolic anterior motion, and one patient benefited from a successful re-repair on day 8 for partial posterior leaflet desinsertion. Mean follow up was 30 months (range: 3-92 months); there were four late deaths (two valve-related cerebrovascular accidents); two patients required re-repair (one after three months for prosthetic ring thrombosis, and one after 10 months for rupture of shortened chordae (corrected by flip-over)). Five patients had MVR between four and 32 months later: one for mitral stenosis due to posterior leaflet calcification, and four for recurrent MR due to the rupture of shortened chordae (n = 3) or plicated papillary muscle (n = 1). One patient suffered bacterial endocarditis which was treated medically. Of the 92 remaining patients with valve repair, 81 are currently asymptomatic, five are in NYHA class II and four in class III. Transesophageal echocardiographic restudy (n = 76) at a mean of 30 months after surgery revealed no MR in 68 patients, and MR of grade <II in three. CONCLUSIONS: AML prolapse repair is safe, durable, and therefore can be attempted even in mildly symptomatic patients. However, chordal shortening should be substituted by implantation of artificial chordae or by the flip-over technique. |
| | |
Authors:
|
G El Khoury; P Noirhomme; R Verhelst; J Rubay; R Dion |
Related Documents
:
|
15017558 - Complications associated with the nuss procedure: analysis of risk factors and suggeste... 10391278 - Early experience with partial left ventriculectomy in the asia-pacific region. 19545068 - Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous m... 16043648 - Current management of severe congenital mitral stenosis: outcomes of transcatheter and ... 22154788 - Staged percutaneous coronary intervention and minimally invasive valve surgery: results... 12837438 - Oxybutynin for diagnosis of infravesical obstruction in boys with urinary incontinence. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of heart valve disease Volume: 9 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 2000 Jan |
Date Detail:
|
Created Date: 2000-03-01 Completed Date: 2000-03-01 Revised Date: 2006-05-04 |
Medline Journal Info:
|
Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: ENGLAND |
Other Details:
|
Languages: eng Pagination: 75-80; discussion 81 Citation Subset: IM |
Affiliation:
|
Cliniques Universitaires Saint-Luc, Brussels, Belgium. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Chordae Tendineae / surgery Female Humans Male Middle Aged Mitral Valve Prolapse / surgery* Polytetrafluoroethylene Postoperative Complications Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
9002-84-0/Polytetrafluoroethylene |
| Comments/Corrections | |
Comment In:
|
J Heart Valve Dis. 2000 Sep;9(5):738-9
[PMID:
11041194
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Ischemic mitral valve repair surgery.
Next Document: Influence of valve replacement on plasma endothelin-1 level in mitral stenosis.