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First Short-Term Outcome after Folding Plication with Goretex Neochordae in Prolapsing Posterior Mitral Leaflet
Devdas T. Inderbitzin1, Babu A. Chiran2, Vineet Mahajan2, Yopie A. Habibie3, Venkat Rao Parachuri2, Oliver Reuthebuch1.
1Clinic for Cardiac Surgery Basel-Bern, University Hospital Basel, Basel, Switzerland, 2Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India, 3Department of Cardiac Surgery, The Zainoel Abidin General Hospital, Aceh, Indonesia.
OBJECTIVE: Among many surgical techniques to address excessive myxomateous posterior mitral leaflet prolapse we describe a simplified, safe and reproducible resection- and annular-plication-free technique to fold the posterior mitral leaflet (PML) utilizing Gore-Tex neo-chordae with minimal risk of postoperative SAM. The first short-term outcome are presented.
METHODS: We provide an illustrative insight in our new mitral folding plication technique and present the first intra-operative and short-term echocardiographic results at discharge (7-10 days) and 6 month postoperatively of the first 50 patients operated on.
RESULTS: 50 patients (12 female, mean age 46.8 ± 15.3) were included. Intraoperative trans-oesophageal and transthoracic follow-up echocardiography at discharge (7-15 days) and 6 month after surgery revealed good mitral leaflet coaptation (minimum 5 mm coaptation length) with absent to trivial residual regurgitation and without SAM in all patients after mitral repair.
CONCLUSIONS: The mitral leaflet folding plication utilizing Gore-Tex neo-chordae is a simple, reproducible and safe method to repair isolated PML prolapse omitting leaflet resection, annular plication and complex measuring and reconstruction at a minimal risk of developing SAM. Further mid- and long-term results are needed to evaluate durable repair by this simple technique. 
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