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Posterior leaflet segment 2 plication in ischemic mitral regurgitation repair

Yasin Ay1, Alper Erkin2, Ibrahim Kara3

  • 1Department of Cardiovascular Surgery, Bezmialem Vakif University, Istanbul, Turkey.

Asian Cardiovascular & Thoracic Annals
|August 13, 2014
PubMed
Abstract

Insights

Plication of posterior leaflet segment 2 with ring annuloplasty significantly reduced mitral regurgitation and improved heart function in patients with ischemic mitral regurgitation. This surgical approach offers a promising option for managing this condition.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Mitral Valve Repair

Background:

  • Functional ischemic mitral regurgitation (FIMR) is a common complication of myocardial infarction.
  • Current surgical options for FIMR include mitral valve repair and replacement, with varying outcomes.
  • Plication of posterior leaflet segment 2 is a technique used in mitral valve repair.

Purpose of the Study:

  • To evaluate the medium-term results of posterior leaflet segment 2 plication combined with ring annuloplasty in patients with FIMR.
  • To assess the impact of this combined surgical approach on mitral regurgitation severity and left ventricular geometry.

Main Methods:

  • A retrospective study of 136 patients who underwent mitral valve repair for FIMR between 2004 and 2012.
  • Surgical technique involved plication of posterior leaflet segment 2 and ring annuloplasty.
  • Pearson correlation analysis was used to assess the relationship between left ventricle sphericity and tethering area in patients with and without recurrent mitral regurgitation.

Main Results:

  • Medium-term survival was 91.9%, and freedom from moderate or severe mitral regurgitation was 89.6%.
  • Transthoracic echocardiography showed significant reductions in tethering area, coaptation height, and intercommissural distance post-surgery (p < 0.0001).
  • A positive correlation was observed between tethering area and left ventricle sphericity in patients with recurrent mitral regurgitation.

Conclusions:

  • Posterior leaflet segment 2 plication combined with ring annuloplasty is an effective procedure for FIMR.
  • The technique leads to significant improvements in mitral valve geometry and reduces regurgitation severity.
  • This approach may be an optional procedure to ensure freedom from moderate or severe mitral regurgitation.
Keywords:
Cardiac surgical proceduresCoronary artery bypassMitral valve annuloplastyMitral valve insufficiencyMyocardial ischemiaVentricular remodeling

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