The Mitral Valve Reconstruction In Patients With Common Mitral Valve Prolapse By Using Pre-measured Gore-tex Loops
Grigory Viktorovich Danilov, Ivan Ivanovich Skopin, Elena Zelikovna Golukhova, Irma Mikhailovna Tsiskaridze.
Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russian Federation.
OBJECTIVE: Early results of reconstructions operations in patients with common mitral valve prolapse by using resection technique and loop technique.
METHODS:A total of 100 patients (65 male,35 female) underwent mitral valve repair with Gore-Tex loops for severe degenerative valve incompetence. 3 of these patients have the Marfan syndrome. The mean age was 52 ± 15, the mean preoperative ejection fraction was 68,2 ± 7,5%, the mean NYHA functional class was 3,57 ± 0,68 and the mean logistic EuroSCORE was 5,12% ±2,12. Posterior mitral leaflet prolapse was diagnosed in 18 patients, anterior leaflet prolapse - in 15 patients, both leaflet prolapse - in the remaining 67 patients.
RESULTS: All patients receiwed the loop technique and the ring annuloplasty, with a mean ring size 32,8 ± 2,57 mm. In 25 patients loops were used for the posterior leaflet only, in 37 patients for the anterior leaflet only, and in 38 patients for both leaflets. Quadrangular resection was performed in 35% of cases. Sliding annuloplasty was performed in 17% of patients. The associated procedures included tricuspid valve reconstruction (75 patients - 75%), myocardial revascularization (18 patients - 18%), David-1 procedure (12 patients), atrial fibrillation ablation (7 patients).
CONCLUSIONS: 1. Multicomponent mitral valve reconstruction by using pre-measured gore-tex loops provides excellent hemodynamic effect.2. The resection techniques must additionally used in patients with excess tissue of the posterior mitral valve.
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