Mitral valve repair. Quadrangular resection of the posterior leaflet in patients with myxomatous degeneration

• Main Authors: Pablo Maria Alberto Pomerantzeff, Carlos Manuel de Almeida Brandão, Eduardo Giusti Rossi, Luís Francisco Cardoso, Flávio Tarasoutchi, Max Grinberg, Noedir Antonio Groppo Stolf, Luiz Boro Puig, Geraldo Verginelli, Adib Domingos Jatene
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cardiologia (SBC) 1999-09-01
• Series: Arquivos Brasileiros de Cardiologia
• Subjects: mitral valve repair; valvular surgery; mitral annuloplasty
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X1999000900003

OBJECTIVE - To analyze the immediate and late results of mitral valve repair with quadrangular resection of the posterior leaflet without the use of a prosthetic ring annuloplasty. METHODS - Using this technique, 118 patients with mitral valve prolapse who underwent mitral repair from January '84 through December '96 were studied. Age ranged from 30 to 86 (mean = 59.1±11.8) years and 62.7% were males. An associated surgery was performed in 22% of the patients, and coronary artery bypass graft was the most frequently performed surgery (15 patients - 12.7%). In 20 (16.9%) patients other associated techniques of mitral valve repair were used and shortening of elongated chordae tendineae was the most frequent one (6 patients). RESULTS - Immediate mortality was 0.9% (one patient). Long-term rates for thromboembolism, endocarditis, re-operation and death in the late postoperative period were 0.4%, 0.4%, 1.7% and 2.2% patients/year, respectively. The actuarial curve of survival was 83.8±8.6% over 12 years; survival free from re-operation was 91.8±4.3%, free from endocarditis was 99.2±0.8% and free from thromboembolism was 99.2±0.8%. In the late postoperative period, 93.8% of the patients were in functional class 1 (NYHA), with a complete follow-up in 89.7% of the patients. CONCLUSION - Patients with mitral valve prolapse who undergo mitral valve repair using this technique have a satisfactory prognosis over 12 years.