Cited 2 times since 2021 (9.9 per year) source: Scopus The Journal of thoracic and cardiovascular surgery, 23 4 2021 Mitral valve repair for isolated posterior mitral valve leaflet prolapse: The effect of respect and resect techniques on left ventricular function. van Wijngaarden AL, Tomšič A, Mertens BJA, Fortuni F, Delgado V, Bax JJ, Klautz RJM, Marsan NA, Palmen M

Objective

Posterior mitral valve leaflet prolapse repair can be performed by leaflet resection or chordal replacement techniques. The impact of these techniques on left ventricular function remains a topic of debate, considering the presumed better preservation of mitral-ventricular continuity when leaflet resection is avoided. We explored the effect of different posterior mitral valve leaflet repair techniques on postoperative left ventricular function.

Methods

In total, 125 patients were included and divided into 2 groups

leaflet resection (n = 82) and isolated chordal replacement (n = 43). Standard and advanced echocardiographic assessments were performed preoperatively, directly postoperatively, and at late follow-up. In addition, left ventricular global longitudinal strain was measured and corrected for left ventricular end-diastolic volume to adjust for the significant changes in left ventricular volumes.

Results

At baseline, no significant intergroup difference in left ventricular function was observed measured with the corrected left ventricular global longitudinal strain (resect

1.76% ± 0.58%/10 mL vs respect

1.70% ± 0.57%/10 mL, P = .560). Postoperatively, corrected left ventricular global longitudinal strain worsened in both groups but improved significantly during late follow-up, returning to preoperative values (resect

1.39% ± 0.49% to 1.71% ± 0.56%/10 mL, P < .001 and respect

1.30% ± 0.45% to 1.70% ± 0.54%/10 mL, P < .001). Mixed model analysis showed no significant effect on the corrected left ventricular global longitudinal strain when comparing the 2 different surgical repair techniques over time (P = .943).

Conclusions

Our study showed that both leaflet resection and chordal replacement repair techniques are effective at preserving postoperative left ventricular function in patients with posterior mitral valve leaflet prolapse and significant regurgitation.

Keywords: Echocardiography, Imaging, Mitral Valve Repair, Mitral Valve Prolapse

J Thorac Cardiovasc Surg. 2021 2