Optimal length of pericardial strip for posterior mitral overreductive annuloplasty

Our recent experience with an autologous pericardium strip to obtain an overreducing posterior mitral annuloplasty is reported. From March 2001 to May 2002, 31 patients underwent this procedure to correct functional (n = 19) or postischemic (n = 12) mitral regurgitation. The length of the pericardium strip was always 4 cm; mean final mitral area was 2.9 cm2, with a mean gradient of 2.9 mm Hg. Eight patients underwent a stress test. Mitral area increased from 3.1 to 3.6 cm2, and the mean gradient increased from 3.1 to 5.2 mm Hg. Residual mitral regurgitation was 0.5 and, when present, remained unchanged at the end of the stress. Overreducing posterior mitral annuloplasty by using a 4-cm pericardial strip gives reproducible results and is effective in correcting functional or postischemic mitral regurgitation. Residual mitral regurgitation, when present, remains stable after stress.