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Quadrangular resection for repair of posterior leaflet prolapse
1Herz und Gefäss Klinik, Cardiac Surgery, Salzburger Leite 1, D-97615 Bad Neustadt/Saale, Germany.
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|January 14, 2014
Summary
Quadrangular resection effectively corrects posterior mitral valve prolapse. This technique, often combined with annular plication or sliding plasty and ring insertion, ensures durable repair and minimizes systolic anterior motion (SAM).
Area of Science:
- Cardiac Surgery
- Mitral Valve Repair
- Cardiovascular Research
Background:
- Posterior leaflet prolapse is a common cause of mitral regurgitation.
- Quadrangular resection has a long-standing history as a reliable surgical technique.
Purpose of the Study:
- To evaluate the long-term efficacy of quadrangular resection for posterior mitral valve prolapse.
- To detail the complementary techniques used to optimize repair outcomes.
Main Methods:
- Quadrangular resection to excise the prolapsed segment of the posterior leaflet.
- Annular plication or sliding plasty for leaflet coaptation and tissue management.
- Mitral ring annuloplasty to complete the repair and prevent recurrence.
Main Results:
- Quadrangular resection successfully addresses the primary defect in posterior leaflet prolapse.
- Adjunctive techniques effectively manage leaflet redundancy and prevent systolic anterior motion (SAM).
- Thirty-year results support the durability and effectiveness of this repair strategy.
Conclusions:
- Quadrangular resection remains the gold standard for posterior mitral valve prolapse repair.
- Combined with appropriate techniques, it offers excellent long-term correction and functional outcomes.
- This approach is crucial for managing complex cases, including those with Barlow's disease.
