Related Experiment Video

Updated: Nov 22, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

1.9K

Clinical impact of the repair technique for posterior mitral leaflet prolapse: Resect or respect?

Taichi Sakaguchi1, Arudo Hiraoka2, Toshinori Totsugawa2

  • 1Department of Cardiovascular Surgery, Hyogo College of Medicine, Hyogo, Japan.

Journal of Cardiac Surgery
|January 11, 2021
PubMed
Abstract

Insights

The "respect" approach for mitral valve prolapse repair resulted in better hemodynamics, including a lower gradient and larger effective orifice area, compared to the "resection" method. Both techniques demonstrated similar midterm durability.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Mitral Valve Repair

Background:

  • Posterior mitral valve prolapse is commonly repaired using leaflet resection or chordal reconstruction.
  • Established techniques include leaflet resection and chordal reconstruction for posterior mitral valve prolapse.

Purpose of the Study:

  • To compare the clinical outcomes of the "resect" and "respect" surgical approaches for posterior mitral valve prolapse.
  • To evaluate the impact of these techniques on mitral valve hemodynamics and repair durability.

Main Methods:

  • A cohort of 291 patients undergoing elective mitral valve repair for isolated posterior leaflet prolapse was analyzed.
  • Patients were categorized into "resection" (leaflet resection alone) and "respect" (neochordal replacement) groups.
  • Early postoperative hemodynamics and midterm repair durability were compared between the two groups.

Main Results:

  • The "respect" group utilized significantly larger annuloplasty rings (31.0 vs. 30.4 mm).
  • The "respect" group exhibited a lower mean mitral valve gradient (2.6 vs. 3.0 mmHg) and a larger effective orifice area (1.86 vs. 1.66 cm²).
  • Five-year freedom from moderate or greater mitral regurgitation was high and similar in both groups (90.9%).

Conclusions:

  • The "respect" approach for mitral valve prolapse repair leads to improved hemodynamic function, evidenced by lower gradients and larger effective orifice areas.
  • This hemodynamic benefit may be attributed to the ability to implant larger annuloplasty rings with the "respect" technique.
  • Both "resect" and "respect" approaches offer comparable midterm durability for mitral valve repair.
Keywords:
leaflet resectionmitral valve repairposterior leaflet prolapserespect approachvalve repair/replacement

More Related Videos

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

4.2K
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.4K

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
115
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
163
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
125
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
166
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
174
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
132