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Arrigo Lessana
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Ann Thorac Surg 1988;45:404-408
© 1988 The Society of Thoracic Surgeons

Articles

Treatment of ruptured or elongated anterior mitral valve chordae by partial transposition of the posterior leaflet: Experience with 29 patients

Arrigo Lessana, M.D.*,a,b,c,**, Mauro Romano, M.D.a,b,c,**, Geneviève Lutfalla, M.D.a,b,c,**, Carmine Carbone, M.D.a,b,c,**, Evelyne Palsky, M.D.a,b,c,**, Sid-Ali Amalou, M.D.a,b,c,**, Marcio Escorsin, M.D.a,b,c,**

a From the Service de Chirurgie Cardio-Vasculaire, CHPA "La Roseraie," Aubervilliers, France
b From the Service de Cardiologie, Hôpital Cochin, Paris, France
c From the Clinique Pédiatrique, Bou Ismail, Algérie

* Address reprints requests to Dr. Lessana, CHPA "La Roseraie," Service de Chirurgie Cardio-Vasculaire, 120 Avenue de la République, 93300 Aubervilliers, France.

We report a series of 29 patients, 5 to 75 years of age (mean age, 31.8 ± 21.4 [SD] years), with pure mitral regurgitation caused by ruptured 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 2 hospital deaths. Follow-up ranged from 1 to 35 months (mean follow-up, 14.9 ± 8.5 months). One patient is lost to follow-up. Two patients are in New York Heart Association Functional Class II; all others are in Class I. In 17 patients there is no detectable murmur; in 5 patients a mild to moderate systolic murmur can be detected, while 4 have a marked systolic murmur. The adequacy of the repair could be confirmed by Doppler echocardiography, which has shown no evidence of prolapse in 22 patients. A mild regurgitation jet is present in 4 patients, and a marked jet, in 3. Postoperative cardiac catheterization performed in 5 patients has confirmed the Doppler echocardiographic findings. Although longer follow-up is necessary, this technique appears adequate for repairing a major prolapse of the anterior leaflet caused by multiple ruptured or elongated chordae, therefore obviating the need for a prosthetic valve substitute.




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