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Repair of the anterior mitral leaflet
J M Alvarez1, D Gray, C Choong
1Department of Cardiac Surgery, Royal North Shore Hospital, Sydney, NSW.
Background:
Repair rather than replacement of the diseased mitral valve has been the goal of the cardiac surgeon. Although well accepted for posterior leaflet pathology, a diseased anterior leaflet was believed by some to be irreparable.
Aims:
To assess the result of reconstructive mitral valve surgery involving the anterior mitral leaflet in a selected group of patients.
Methods:
Twenty consecutive patients with degenerative (19), ischaemic (one) and congenital/calcific mitral regurgitation were evaluated. There were five females and 15 males with a mean age of 62 +/- 12 years (41-75 years). The technique used to repair these valves included chordal transposition, leaflet plication commissuroplasty and a new technique we call leaflet repositioning.
Result:
There were no deaths, follow-up is complete with mean follow-up of 31 +/- five months (two-102) months. All patients have had 2DE and 13 TOE as well. There have been no reoperations due to failure of the repair, 95% of patients are in NYHA Class I-II post operative, while 15% have significant residual regurgitation.