Literature DB >> 33381428

Triangular resection versus folding repair for simple posterior mitral leaflet lesions: case-control study.

Ken Nakamura1, Kouan Orii1, Takayuki Abe1, Hirofumi Haida1, Kazuhiro Hashimoto2, Takashi Kunihara2.   

Abstract

BACKGROUND: A triangular resection (TR)/suture of the posterior leaflet lesion is the most common technique in mitral valve repair procedures. However, posterior leaflet motion is restricted after surgical resection in echocardiogram analyses. Although several reports have compared the resection/suture technique and the artificial chorda technique, few reports have compared TR with folding repair (FR). We compared the effectiveness and short-term impact of the TR and non-resection-based FR procedures on patients undergoing mitral valve repair.
METHODS: Mitral valve repair was conducted on 36 patients with moderate to severe mitral regurgitation (MR) through either TR (n=18) or FR (n=18). Echocardiographic data were collected pre- and post-operatively. Routine echocardiographic follow-ups were performed for each patient. Data were analyzed using t-test, Mann-Whitney U-test, chi-squared analysis, or Fisher's exact test. P values <0.05 were considered significant.
RESULTS: Operative time and length of stay within the intensive care unit and hospital did not significantly differ between the two techniques. Post-operative echocardiographic results showed a significantly larger mitral valve area after FR (P=0.029). The regurgitation regression rate was 94% under mild MR in the FR group (1 case; severe) and 88.8% in the TR group (2 cases; moderate) during the same duration.
CONCLUSIONS: Both techniques showed comparable outcomes and durability. However, FR is relatively simple and it is possible to re-initiate FR procedures; thus, it may also provide an opportunity for less-experienced surgeons to conduct valve repair surgeries. The study was registered with the University Hospital Medical Information Network (study ID: UMIN000039041). 2020 Cardiovascular Diagnosis and Therapy. All rights reserved.

Entities:  

Keywords:  Triangular resection (TR); folding repair (FR); mitral valve repair

Year:  2020        PMID: 33381428      PMCID: PMC7758764          DOI: 10.21037/cdt-20-760

Source DB:  PubMed          Journal:  Cardiovasc Diagn Ther        ISSN: 2223-3652


  17 in total

1.  Left ventricular performance early after repair for posterior mitral leaflet prolapse: Chordal replacement versus leaflet resection.

Authors:  Ken-ichi Imasaka; Eiki Tayama; Yukihiro Tomita
Journal:  J Thorac Cardiovasc Surg       Date:  2015-06-18       Impact factor: 5.209

2.  Transvalvular pressure gradients for different methods of mitral valve repair: only neochordoplasty achieves native valve gradients.

Authors:  Silje Ekroll Jahren; Samuel Hurni; Paul Philipp Heinisch; Bernhard Winkler; Dominik Obrist; Thierry Carrel; Alberto Weber
Journal:  Interact Cardiovasc Thorac Surg       Date:  2018-02-01

3.  Surgical Treatment of Posterior Mitral Valve Prolapse: Towards 100% Repair.

Authors:  Pedro M Correia; Gonçalo F Coutinho; Carlos Branco; Ana Garcia; Manuel J Antunes
Journal:  J Heart Valve Dis       Date:  2015-11

4.  Mitral valve hemodynamics after repair of acute posterior leaflet prolapse: quadrangular resection versus triangular resection versus neochordoplasty.

Authors:  Muralidhar Padala; Scott N Powell; Laura R Croft; Vinod H Thourani; Ajit P Yoganathan; David H Adams
Journal:  J Thorac Cardiovasc Surg       Date:  2009-08       Impact factor: 5.209

5.  A simplified approach to degenerative disease: triangular resections of the mitral valve.

Authors:  Leo M Gazoni; Lynn M Fedoruk; John A Kern; John M Dent; T Brett Reece; Curtis G Tribble; Philip W Smith; Turner C Lisle; Irving L Kron
Journal:  Ann Thorac Surg       Date:  2007-05       Impact factor: 4.330

6.  One Hundred Percent Reparability of Degenerative Mitral Regurgitation: Intermediate-Term Results of a Dynamic Engineered Approach.

Authors:  Gerald M Lawrie; William Zoghbi; Stephen Little; Dipan Shah; Zegit Ben-Zekry; Nan Earle; Elizabeth Earle
Journal:  Ann Thorac Surg       Date:  2015-09-26       Impact factor: 4.330

7.  Early outcome of folding mitral valve repair technique without resection for mitral valve prolapse in 60 patients.

Authors:  Hiroyuki Tsukui; Nobuhiro Umehara; Hiroyuki Saito; Satoshi Saito; Kenji Yamazaki
Journal:  J Thorac Cardiovasc Surg       Date:  2012-11-03       Impact factor: 5.209

8.  "Respect when you can, resect when you should": A realistic approach to posterior leaflet mitral valve repair.

Authors:  Gilles D Dreyfus; Filip Dulguerov; Cecilia Marcacci; Shelley Rahman Haley; Antonia Gkouma; Carine Dommerc; Adelin Albert
Journal:  J Thorac Cardiovasc Surg       Date:  2018-05-28       Impact factor: 5.209

9.  Toward a new paradigm for the reconstruction of posterior leaflet prolapse: midterm results of the "respect rather than resect" approach.

Authors:  Patrick Perier; Wolfgang Hohenberger; Fitsum Lakew; Gerhard Batz; Paul Urbanski; Michael Zacher; Anno Diegeler
Journal:  Ann Thorac Surg       Date:  2008-09       Impact factor: 4.330

10.  Chordae replacement versus resection for repair of isolated posterior mitral leaflet prolapse: à ègalité.

Authors:  Joerg Seeburger; Volkmar Falk; Michael A Borger; Jurgen Passage; Thomas Walther; Nicolas Doll; Friedrich W Mohr
Journal:  Ann Thorac Surg       Date:  2009-06       Impact factor: 4.330

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