Mitral Valve Plasty Without Cutting the Leaflet

Hiroki Kato, Hirofumi Takemura, Kenji Iino, Hideyasu Ueda, Hironari No, Shintaro Takago, Yoshiko Shinatani

Kanazawa University, Kanazawa, Japan

Date, time and location: 2018.05.25 10:30, Exhibition area, 1st Floor. Zone – D

Abstract

Background:

In mitral valve plasty, it is controversial which is better cutting the leaflet or not. In our institute we performed leaflet preserved mitral plasty.

The merit of mitral plasty without cutting leaflet is it is possible to change the width of plication and/or try other techniques if residual regurgitation is present after first procedure. We present our experience of this procedure.

Methods:

From January 2015 to November 2017, 64 patients underwent mitral plasty.

Our strategies

1. Annular dilatation without leaflet prolapse→ annuloplasty

2. Posterior leaflet prolapse area is less than 1/3 for each segment→ plication technique

3. Posterior leaflet prolapse area is more than 1/3 for each segment→ small double plication technique and/or neochordae implantation

4. Prolapse near the commissure leaflet→ fixation technique

5. Anterior leaflet prolapse and posterior leaflet prolapse area is over than 1/3 for each segment→ neochoedae implantation

6. Severe thick leaflet→ leaflet slicing and/or resection

Mean age was 66.8±8.9, preoperative MR grade was 3.5±0.5 and preoperative ejection fraction was 56.8±10.1%.

Results:

Total number of changing the width of plication and/or trying other techniques was 11 (17%). The number of leaflet resection was 4 (6%). Mean postoprative MR grade was 0.5 ( Mean postoperative EF was 54.5±9.4%. There were no hospital death within 30 POD and major complication. Average follow-up period was 17.4 months. There is no reoperation due to residual mitral regurgitation.

Conclusions: