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Echocardiographic assessment of mitral valve morphology and performance after triangular resection of the prolapsing posterior leaflet for degenerative myxomatous disease

^a Department of Cardiac Surgery, Giuseppe Mazzini Hospital, Piazzale San Padre Pio, 64100 Teramo, Italy
^b Department of Cardiac Surgery, Clinic Center of Podgorica, Montenegro

*Corresponding author. Tel.: +39 0861 429686; fax: +39 0861 429687.

E-mail address: sandromaz{at}tin.it (A. Mazzola).

The gold standard for the surgical treatment of prolapse of the posterior leaflet of the mitral valve (MV) for degenerative myxomatous disease has been represented by the quadrangular resection of the leaflet, according to the Carpentier technique. Since 2006 we performed a triangular resection of the prolapsing leaflet in 20 patients with myxomatous mitral regurgitation (MR). Seventeen patients (85%) underwent the triangular resection of P2; one patient (5%) had a triple scallops triangular resection (P1, P2, P3) and two (10%) a double scallops (P2, P3) resection. In this study, we report the immediate and mid-term clinical and echocardiographic results of a cohort of 20 patients, who underwent this technique. Thirty-day mortality was 0. Acute renal failure occurred in three patients (15%) and they resolved with conservative management. One patient (5%) required re-exploration for bleeding. At the mean follow-up of 13.1±4.2 months survival was 95%; one patient died of lymphoma during the follow-up time. All the cases were in New York Heart Association (NYHA) class I. Nineteen survivors underwent transthoracic echocardiography (TTE) (5), or transesophageal echocardiography (TEE) (13), performed by two skilled cardiologists. All patients showed no or trivial MV regurgitation. We believe that triangular resection of posterior MV leaflet (PMVL) provides excellent mid-term results providing the surgeon with a reliable and reproducible surgical option for myxomatous degenerative MV regurgitation.

Key Words: Mitral valve repair

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eComment: Should triangular resection be an adequate approach for prolapsing posterior leaflet in all types of degenerative mitral valve disease?

Leo A. Bockeria, Ivan I. Skopin, and Irma M. Tsiskaridze
Interactive CardioVascular and Thoracic Surgery 2009 9: 290. [Full Text] [PDF]

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				L. A. Bockeria, I. I. Skopin, and I. M. Tsiskaridze eComment: Should triangular resection be an adequate approach for prolapsing posterior leaflet in all types of degenerative mitral valve disease? Interactive CardioVascular and Thoracic Surgery, August 1, 2009; 9(2): 290 - 290. [Full Text] [PDF]