How does the use of polytetrafluoroethylene neochordae for posterior mitral valve prolapse (loop technique) compare with leaflet resection? A prospective randomized trial

摘要: Objective Mitral valve surgery for posterior mitral leaflet prolapse consists mostly of resection, but implantation premeasured polytetrafluoroethylene neochordae (ie, loops) is another option. The aim this prospectively randomized trial was to determine how preservation structure in combination with compares the widely adopted technique resection. Methods A total 129 patients severe regurgitation, a mean regurgitation grade 3.6 ± 0.6, underwent minimal invasive through right lateral mini-thoracotomy. age 59.5 12 years, 90 were male, preoperative ejection fraction 65% 8%, and New York Heart Association functional class 2.1 0.7. Posterior diagnosed all patients. Randomization performed preoperatively, crossover allowed if surgeon deemed it medically necessary. Crossover from resection loops occurred 9 patients, 3 Results repair accomplished (n = 129, 100%), received an annuloplasty ring. number implanted on 3.2 0.9, length 13.3 2.2 mm. duration cardiopulmonary bypass 135 37 minutes aortic crossclamp time 82 26 no significant difference between groups. Intraoperative transesophageal echocardiography showed significantly longer line coaptation after (7.6 mm) than (5.9 2.6 mm; P .03). Thirty-day mortality 1.6% entire group (2/129), both deaths occurring loop group. Cause death massive pulmonary embolism 1 patient acute heart failure patient. Early mid-term echocardiographic follow-up revealed excellent function majority orifice area (3.6 1.0 cm 2 vs 3.7 1.1 , .4). Conclusion Both techniques are associated results appear comparable early postoperative course. technique, however, may therefore be more durable. Longer required.