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Ann Thorac Surg 2001;72:1794-1795
© 2001 The Society of Thoracic Surgeons

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Correspondence

History of mitral valve anterior leaflet repair with triangular resection

^a Division of Cardiothoracic Surgery, New York University School of Medicine, 530 First Ave, Suite 9V, New York, NY 10016, USA

To the Editor

In their study, Doctors Fasol and Joubert-Hübner present a series of 18 patients with isolated degenerative anterior leaflet disease repaired by triangular resection completed with a ring annuloplasty [1]. This study documents good perioperative results with no mortalities, valve failures, or incidence of postoperative systolic anterior motion (SAM). The authors do a disservice to the reader, however, by not reviewing the history of this surgical technique and the full range of results associated with it. Triangular resection of the anterior leaflet was originally described by Carpentier and colleagues in the 1970s [2]. Subsequently, however, he recommended avoidance of this technique due to concerns regarding long-term results [3]. In 1994, we reported a series of 23 patients with excessive anterior leaflet tissue in whom the triangular resection technique was successfully used and noted its association with a decreased incidence of postoperative SAM [4]. Furthermore, in 1995, we reported 5-year follow-up results on 156 anterior leaflet repairs showing a 91.9% freedom from reoperation [5]. The incidence of failure among the 44 patients in this group who underwent a triangular resection was 4.5% (2 of 44) which was similar to that of other techniques evaluated in the same study [5]. Currently, we have performed over 180 triangular resections of the anterior leaflet with results comparable to those in our previous report.

We submit that our published data support the authors’ speculation that appropriate use of anterior triangular resection would have an excellent long-term outcome and would be associated with a decreased incidence of postoperative SAM.

References

1. Fasol R., Joubert-Hübner E. Triangular resection of the anterior leaflet for repair of the mitral valve. Ann Thorac Surg 2001;71:381-383.[Abstract/Free Full Text]
2. Carpentier A., Relland J., Deloche A., et al. Conservative management of the prolapsed mitral valve. Ann Thorac Surg 1978;26:294-302.[Abstract]
3. Carpentier A. Cardiac valve surgery—the "French correction". J Thorac Cardiovasc Surg 1983;86:323-337.[Medline]
4. Grossi E.A., Steinberg B.M., LeBoutillier M., III, et al. Decreasing incidence of systolic anterior motion after mitral valve reconstruction. Circulation 1994;90(5 Pt 2):II195-II197.
5. Grossi E.A., Galloway A.C., LeBoutillier M., III, et al. Anterior leaflet procedures during mitral valve repair do not adversely influence long-term outcome. J Am Coll Cardiol 1995;25:134-136.[Abstract]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Eugene A. Grossi Angelo LaPietra Aubrey C. Galloway Stephen B. Colvin Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Grossi, E. A. Articles by Colvin, S. B. Search for Related Content PubMed Articles by Grossi, E. A. Articles by Colvin, S. B. Related Collections Valve disease