"Repair for the prolapse of the anterior mitral valve leaflet with chordal transfer based on the ""edge-to-edge"" technique"
10.3760/cma.j.issn.1673-4904.2011.29.004
- VernacularTitle:“缘对缘”技术基础上的腱索转移法治疗二尖瓣前叶脱垂
- Author:
Chengshan GAO
;
Hui JIN
;
Guanglong SUN
;
Guozhang MAO
;
Liuguang WU
;
Lei HE
;
Caoyuan ZHU
- Publication Type:Journal Article
- Keywords:
"Mitral valve prolapse;
Technique of ""edge-to-edge"";
Chordal transfer"
- From:
Chinese Journal of Postgraduates of Medicine
2011;34(29):12-14
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce a kind of operative technique in repair for the prolapse of the anterior mitral valve leaflet.Methods From January 2004 to October 2010,the operation of chordal transfer based on theedge-to-edge technique was performed in 18 cases with serious mitral valve regurgitation because of prolapse of the anterior leaflet.First,the edge-to-edge suturing was performed at the free edge of the prolapsed anterior leaflet with corresponding posterior leaflet.After that,quadrangular resection was performed to transfer these segments of posterior leaflet with its attached chordae.At last,the posterior leaflet was repaired after a quadrangular resection which would be much easier for the surgeons.After the operation,echocardiography was performed in each patient before discharge and at the time of follow-up.Results All patients survived after the operation,1 case required the rnitral valve replacement because of anterior leaflet performation occurring 3 days after the operation,1 case with hemoglobinuria and 1 case with low cardiac output,who all got symptomatic treatment afterwards.All the other patients were well discharged.At the time of follow-up,all of the patients were in NYHA functional class I.In all these patients,pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve:the cross-sectional area of the mitral valve was 2.8-4.8 (3.78 +0.52) cm2,the mean regurgitation area was (0.45 +0.22) cm２.At the same time,both dimension of left atrium and left ventricular reduced significantly [ left atrium diameter:pre-operation ( 48.26 + 11.12 ) mm,post-operation ( 37.57 ± 9.56) mm (P ＝ 0.028 );the end-diastolic diameter of the left ventricular:pre-operation(61.43 ± 8.24) mm,post-operation (42.35 ±10.79) mm (P＝0.008)].Conclusion Chordal transfer based on the edge-to-edge technique provides good results for repair of anterior leaflet prolapse.
