Mitral posterior leaflet extension

Abstract

Reconstructive surgery of mitral valve has improved during the past 25 years. The lack of leaflet tissue causes retraction and prevents successful result for maintenance of coaptation after annuloplasty procedure. Valve extension with autologous pericardium represents a solution to this problem. For this reason, autologous pericardium has been used in a series of 36 patients who underwent operations for leaflet extension of mitral valve reconstruction between 1990-1995. There were 29 female and 7 male patients whose mean age was 32.7, range 16 to 64. Associated mitral valve repair techniques have been used 24 patients. Seven of them underwent additional annulo-plasty procedure, most of them underwent different types of associated reconstructive procedures (commissurotomy, resection of secondary chordae tendineae not attacked to free margin of leaflets, fenestration of fused chordae, chordae tendineae splitting papillary muscle splitting, chordae tendineae shortening. There was only one patient who underwent mitral valve replacement for recurrent mitral valve insufficiency 11 months later. Postoperative mitral valve function was assessed by two-dimensional color Doppler echocardiographic techniques. Postoperative mitral valve insufficiency was trivial or absent in the series. We conclude that leaflet extension is a safe technique in valve reconstruction, allowing the repair of mitral valves that otherwise would need to be replaced.