Surgical repair of the prolapsing anterior leaflet in degenerative mitral valve disease.

摘要: BACKGROUND AND AIM OF THE STUDY: Repair of the prolapsing anterior leaflet (AML) in degenerative mitral valve disease is more demanding than that posterior leaflet. We reviewed our experience past eight years, to examine safety, efficacy and stability various repair artifices. METHODS: Between January 1989 December 1997, 102 patients (mean age 64 years; range: 26-86 years) with regurgitation (MR) due prolapse or both leaflets underwent repair. Sixty-six were NYHA class > =III, 94 had MR grade >II. Acute endocarditis was present 12 Barlow 16. Surgical techniques consisted chordal shortening (n = 36), transposition 16), papillary muscle plication 10), flip-over 20) artificial chordae implantation 20). RESULTS: There no early mortality; one patient required replacement (MVR) for late-appearing systolic motion, benefited from a successful re-repair on day 8 partial desinsertion. Mean follow up 30 months (range: 3-92 months); there four late deaths (two valve-related cerebrovascular accidents); two (one after three prosthetic ring thrombosis, 10 rupture shortened (corrected by flip-over)). Five MVR between 32 later: stenosis calcification, recurrent 3) plicated 1). One suffered bacterial which treated medically. Of 92 remaining repair, 81 are currently asymptomatic, five II III. Transesophageal echocardiographic restudy 76) at mean surgery revealed 68 patients,