A simple approach to a new technique for correction of posterior mitral leaflet prolapse
Farouk M. Oueida1, Ibrahim M. Yassin2, Mustafa Al Refaei1, Khaled A Eskander1.
11Saud al-Babtin Cardiac Center, Aldammam, Saudi Arabia, 2Tanta University Hospitals, Tanta, Egypt.
OBJECTIVE: One of the techniques that did not imply resection of any posterior leaflet (PL) scallop, or part of it, for correction of PL prolapse is the U-Technique, with provisional excellent short-midterm results. Some have expressed concern, however, that minimal invasive (MI) techniques may lead to inferior results for mitral valve (MV) surgery.
METHODS: From March 2012 to March 2015, Fifteen patients with a main MV pathology of PL prolapse underwent (MI) (MV) repair via a 5-7 cm right antero-lateral thoracotomy with peripheral cannulation and external aortic clamping. Mean age, Female/Male, LVEF and NYHA class were 28 ± 11 years, 2/1, 44 ± 7% and 3.1 ± 0.8. Custodiol cardioplegia via aortic root was utilized in all patients. Main finding of this technique is that PL prolapse can be corrected only by annular over-reduction associated to scallop suturing, and if necessary to longitudinal plication of the scallops to make uniform their height 9 cases (60%). 3-D rings were implanted in all of the 15 cases (100%).
RESULTS: All procedures were successfully performed with no/mild residual mitral regurgitation (MR), Mean Trans Mitral pressure gradient was 2.3 ± 1.1. No systolic anterior motion (SAM). Mean aortic cross-clamp and bypass times were 108 ± 23 and 141 ± 31 min. respectively. No hospital mortality. At a mean follow-up of 6±8.2 months, all patients are alive with a freedom from ≥2+ degree of MR of 100% and preserved LVEF.
CONCLUSIONS: U-Technique via (MI) approach is feasible, safe and provides comparable excellent early-midterm results.
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