Posterior mitral annuloplasty using autologous pericardium in the repair of posterior leaflet prolapse.

OBJECTIVE

Mitral valve repair is frequently performed now because it produces a favorable postoperative quality of life, as well as improved cardiac function. For the treatment of posterior leaflet prolapse, we perform a posterior mitral annuloplasty using an autologous pericardium. The present study assessed the efficacy of this operation.

METHODS

From April 1999 to October 2003, 42 patients underwent a posterior mitral annuloplasty using autologous pericardium for the treatment of posterior leaflet prolapse. There were 15 men and 27 women with an average age of 63.9 +/- 11.8 years. The length of the autologous pericardium matched the length of the posterior leaflet annulus as measured with Carpentier-Edwards ring sizer that was chosen based on the area of the anterior leaflet.

RESULTS

The average size of the Carpentier-Edwards ring sizer that was used to determine the length of the autologous pericardium was 27.7 +/- 13 mm, and the absolute length of the pericardium was 50.9 +/- 1.8 mm, and the average intraoperative jet area, as assessed by transesophageal echocardiography, was 0.36 +/- 0.47 cm2. The five-year freedom from reoperation was 97.1%, while the freedom from significant residual mitral regurgitation (> or = 3+/4+) was 92.0%. Two patients (4.8%) developed systolic anterior motion, and one patient (2.4%) had a cerebral infarction. None of the patients died after surgery, and no patients developed complications such as hemolysis or ring detachment.

CONCLUSIONS

Posterior mitral annuloplasty using an autologous pericardium was shown to be a superior technique because it allows a sufficient annular repair with no complications such as hemolysis or ring detachment.