Chordal replacement versus quadrangular resection for repair of posterior mitral leaflet prolpase

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Günther, T, Nöbauer, C, Kiefer, B, Mazzitelli, D, Busch, R, Tassani-Prell, P, Lange, R
• Format: Conference Proceeding
• Language: English
• Published: 01.02.2008
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-2008-1037789

Objective: The current study compared midterm results of mitral valve repair with artificial chordal replacement versus classic posterior leaflet quadrangular resection in a large group of patients with posterior mitral leaflet prolapse Methods: 214 consecutive patients were analyzed, who underwent mitral valve (MV) reconstruction between 2002 and 2005. 151 patients (70.6%) underwent posterior leaflet quadrangular resection (group R:“resection“) and 63 patients (29.4%) underwent a neochordal repair (group NR „no resection“). In all patients a Colvin Galloway Futureband was used for ring stabilization The follow up is 99% complete (mean follow up of 210 survivors 1.95±1.1 years) Results: Thirty day mortality was 0.5%. Three (1.4%) patients died late after 1.1±1.67 years. Actuarial survival at 4 years in group R and NR was 96±3.6% and 98±2.2%, respectively (p=0.16). Four patients (1.9%) required a MV related reoperation after an average of 2.6±2.4 months. Freedom from reoperation at 4 years in group R and NR was 97.4±1.5% and 100%, respectively (p=0.28). Generally in patients of group NR a larger annuloplasty device could be implanted (mean size 31.4±2.4 versus 30.5±1.9, p=0.008). At latest follow-up 94% of the patients showed trivial or mild MV regurgitation with no difference between groups. Conclusion: Repair of posterior mitral leaflet prolapse by chordal replacement is equally effective as quadrangular resection and can be performed with excellent early results and a low incidence of reoperation