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Ann Thorac Surg 2007;83:724
© 2007 The Society of Thoracic Surgeons

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Correspondence

Edge-to-Edge Technique for Residual Mitral Valve Regurgitation

Great Ormond Street Hospital, Department of Cardiothoracic Surgery, Great Ormond Street, London, WC1N 3JH United Kingdom

(Email: prathi_naga{at}hotmail.com).

To the Editor:

I read the article on the midterm results of the edge-to-edge (E2E) technique by Brinster and colleagues [1] with interest. I congratulate the authors for organizing a difficult study on the effect of E2E repair in handling systolic anterior motion and its prevention. Although I am impressed with the results, I ponder over a few queries that arise in my mind. First of all, the two groups are heterogeneous with respect to operative details. There are only 24 incidences of leaflet advancements or posterior leaflet resection, while the preoperative pathology showed that at least 30 patients had some form of anterior leaflet prolapse and 39 had posterior prolapse. Even though the numbers are impressive in the groups, the mere fact that there is a difference in the types of treatment techniques between groups shows that the groups are not comparable between each other. We all agree that the E2E technique specifically addresses the issue of managing residual mitral regurgitation to some extent, but to conclude that E2E is not efficacious is difficult from the study point of view. Moreover, there are no comparisons between the two groups about the pre-repair grades of mitral regurgitation. In such a condition, it is difficult to assume that this technique was not effective in either of the groups to treat the residual complex regurgitation. However the impression conveyed at the end of article is such that the technique is effective to correct mitral regurgitation in association with elements of systolic anterior motion (SAM) predictors, although if there are no such predictors that exist, then the technique is not at all effective. From the way the groups are compared, it is difficult to draw any conclusion in these lines. It may be possible to say that the SAM potential is treated with this technique and none more than that. We will probably need a larger cohort with matched controls to determine the exact efficiency of this repair technique in correcting complex mitral regurgitation.

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1. Brinster DR, Unic D, D’Ambra MN, et al. Midterm results of the edge-to-edge technique for complex mitral valve repair Ann Thorac Surg 2006;81:1612-1617.[Abstract/Free Full Text]

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				D. R. Brinster and L. H. Cohn Reply. Ann. Thorac. Surg., February 1, 2007; 83(2): 724 - 725. [Full Text] [PDF]

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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nagarajan Muthialu Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Muthialu, N. Search for Related Content PubMed PubMed Citation Articles by Muthialu, N. Related Collections Valve disease Related Article