Comparison of Anterior Mitral Leaflet Repair Techniques with and without the Use of Chordal Replacement in Patients with Degenerative Mitral Valve Insufficiency

• Published in: The Heart surgery forum Vol. 22; no. 3; p. E234
• Main Authors: Kadiroğulları, Ersin, Çiçek, Ömer Faruk, Mola, Serkan, Yaşar, Emre, Erkengel, İbrahim, Yalçınkaya, Adnan, Günertem, Eren, İkbaliafşar, Ferhat, Diken, Adem, Kocabeyoğlu, Sabit, Lafçı, Gökhan, Çağlı, Kerim
• Format: Journal Article
• Language: English
• Published: United States 24-05-2019
• Subjects: Adolescent; Adult; Aged; Cohort Studies; Female; Heart Valve Prosthesis Implantation - adverse effects; Humans; Male; Middle Aged; Mitral Valve Annuloplasty - adverse effects; Mitral Valve Insufficiency - surgery; Postoperative Complications - epidemiology; Recurrence; Reoperation; Survival Rate; Treatment Outcome; Young Adult
• ISSN: 1522-6662
• DOI: 10.1532/hsf.2317

The aim of our study was to compare the outcome of patients who underwent mitral valve anterior leaflet repair with and without chordal replacement for degenerative mitral valve insufficiency.
This study was conducted at our center between May 2006 and May 2013. The study included 125 patients with degenerative mitral valve insufficiency (64 males, 61 females; mean age 47 years, age range 16-78 years) who underwent mitral valve repair with anterior leaflet procedures. The patients were divided into 2 groups. Group A consisted of 56 patients with chordal replacement, and group B consisted of 69 patients with other repair techniques performed.
No significant difference was determined between the 2 groups in mortality, recurrence, and reoperation rates. The mortality rate was 3.6% in group A and 1.4% in group B. During the follow-up period, 3 patients were reoperated on (mitral valve replacement) because of severe mitral valve insufficiency. Two of these patients were from group A (3.6%), and the other was from group B (1.4%). One patient in group A underwent intraoperative mitral valve replacement after unsuccessful chordal replacement. Fifty patients (89.3%) in group A and 65 patients (94.2%) in group B exhibited no or mild recurrence of mitral valve insufficiency.
Mitral valve repair in patients with degenerative mitral valve insufficiency resulting from anterior leaflet pathology is a safe procedure because of its durability and good long-term results. Despite the difficulty of the chordal replacement procedure, it may be used as an alternative technique for anterior mitral valve leaflet repair.