Prolapsed Anterior Mitral Valve: Surgical Treatment by Partial Transposition of the Posterior Leaflet
We report a series of 35 patients, 5–75 years of age (mean: 32.74±22.94), with pure mitral regurgitation caused by ruptured and/or elongated chordae of the anterior mitral leaflet. These patients underwent mitral valve repair by segmental transposition of the posterior leaflet with its attached chordae sutured to the free edge of the flail anterior leaflet. There were two hospital deaths. The follow-up period ranged from 1 to 45 months (mean: 20.91±11.5 months). One patient is lost to follow-up. One patient had an early mitral valve replacement due to evolutive endocarditis. Two patients are in NYHA class II. All others are in class I. In 21 patients there is no detectable murmur, in six patients a mild to moderate systolic murmur can be detected while four have a significant systolic murmur. The adequacy of the repair could be confirmed by Doppler echocardiography, which showed no evidence of prolapse in 22 patients. A mild regurgitation jet is present in five patients and a significant jet in three. This technique appears adequate for repairing a significant prolapse of the anterior leaflet caused by multiple ruptured and/or elongated chordae, therefore obviating for the need of a prosthetic valve substitution.
KeywordsMitral Valve NYHA Class Mitral Valve Repair Systolic Murmur Mitral Valve Disease
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