Intermediate-term outcomes of our original multiple-knot technique using ePTFE sutures for anterior mitral leaflet prolapse
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To define the outcomes of our original simple chordal replacement technique using ePTFE sutures for mitral regurgitation.
Between January, 2004 and March, 2014, 38 patients underwent mitral valve repair using our chordal replacement technique for anterior leaflet prolapse. The mitral regurgitation was caused by degenerative disease in 34 patients and infective endocarditis in 4 patients.
The follow-up period was 66 ± 37 months and the 5-year survival rate was 95 ± 4%. Two patients had recurrent mitral regurgitation, caused by degenerative change not associated with the procedure. The 5-year rate of freedom from recurrent mitral regurgitation was 94 ± 4%. In the late postoperative period, 15 (42%) patients had a mean pressure gradient > 5 mmHg. Stepwise logistic regression analysis showed that the use of a full ring (odds ratio 8.9; 95% confidence interval 1.2–64; p = 0.031) and a 26 mm annuloplasty (odds ratio 7.5; 95% confidence interval 1.1–50; p = 0.037) were significant independent risk factors for a mean pressure gradient > 5 mmHg.
The intermediate-term outcomes of our original chordal replacement technique were not inferior to those in previous reports, although a 26 mm annuloplasty was found to be associated with a higher mitral valve gradient at rest.
KeywordsMitral valve Mitral regurgitation Mitral valve repair Artificial chordae Functional mitral stenosis
This study was presented at the 67th Annual Scientific Meeting of the Japanese Association for Thoracic Surgery, Fukuoka, Japan, September 30 to October 3, 2014. We thank the ultrasound technicians for their technical contribution to this study, and Mariko Yamashita for her great help with clinical data collection.
This research was partially supported by research funds to promote the hospital function of the Japan Labor Health and Welfare Organization.
Compliance with ethical standards
Conflict of interest
We have no conflicts of interest to report.
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