Posterior mitral leaflet repair with a simple segmental annulus support: the 'double-Teflon technique'.

Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
The Journal of heart valve disease (Impact Factor: 1.07). 04/2002; 11(2):160-4.
Source: PubMed

ABSTRACT The study aim was to present immediate and late results of a modified technique for mitral valve repair--the 'double-Teflon technique'. This consists of quadrangular resection of the posterior leaflet, annulus plication with 'pledgetted' stitches over a Teflon patch, and leaflet suture.
Seventy-two patients (41 males, 31 females; mean age 60.5+/-11.9 years) with mitral insufficiency due to myxomatous degeneration and ruptured or elongated chordae tendineae underwent mitral valve repair with this technique. Fifteen patients (18%) had associated cardiovascular disease including coronary artery disease, aortic insufficiency, aortic stenosis and atrial septal defect. Operative, immediate postoperative and late operative echocardiographic data of the first 29 patients were analyzed. Actuarial survival was assessed using the Kaplan-Meier method.
There was one operative death (1%). By the late postoperative period, 95% of survivors were in NYHA functional class I. There were no episodes of hemolysis or endocarditis; the linearized rate for thromboembolism was 1.4%/patient-year. Actuarial survival at 72 months was 94.5+/-3.2%. Doppler echocardiography showed a significant decrease in mean left atrial diameter (p = 0.0001) and left ventricular diastolic diameter (p = 0.0003).
Mitral valve repair with the 'double-Teflon technique' is associated with low operative mortality, satisfactory survival rates, and good clinical outcome.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A trigone-to-trigone semirigid annuloplasty band (C-G Future Band, Medtronic, Inc., Minneapolis, Minnesota, USA) was introduced in 2001 for mitral valve repair. We report our early clinical and echocardiographic results with this new device to correct ischemic mitral regurgitation. Between January 2002 and December 2004, among 216 patients operated on for mitral regurgitation, 107 patients had a C-G Future Band annuloplasty and 85 consecutive patients (72.6% male; mean age 66.9 +/- 8.6 years) received this annuloplasty band to correct ischemic mitral regurgitation. Mean follow-up was 14.3 +/- 9.8 months (range 0.2-37 months). Clinical and echocardiographic assessment was accomplished preoperatively, postoperatively, at 6 and 12 months, and at two years. Perioperative mortality was 3.7% (three in-hospital deaths), whereas overall survival at two years was 88.7 +/- 4.2%. Immediately after repair, echocardiographic mitral regurgitation was dramatically reduced (2.5 +/- 0.6 vs. 0.9 +/- 0.6; P < 0.0001); ejection fraction increased from 43.8 +/- 11% preoperatively to 44.8 +/- 12% postoperatively (P = 0.007). At the time of follow-up, New York Heart Association (NYHA) functional class was significantly improved (mean preoperative NYHA class 2.04 +/- 0.9 vs. mean postoperative NYHA class 1.25 +/- 0.6; P < 0.0001). No patient experienced thromboembolic events and no late mitral valve reoperation occurred. Early and mid-term mitral valve function is satisfactory with trigone-to-trigone semirigid band annuloplasty, with excellent repair durability immediately after the operation and at two years. Moreover, after annuloplasty repair, an improvement in clinical functional status is obtained. A wider use of this semirigid annuloplasty band can be recommended.
    Journal of Cardiovascular Medicine 07/2007; 8(7):499-503. · 2.66 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this paper is to present the late clinical results of mitral valve repair with the "Double Teflon" technique. "Double Teflon" technique consists of a quadrangular resection of the posterior leaflet, annulus plication with "pledgetted" stitches over a Teflon patch, and leaflet suture. Between 1994 and 2003, 133 patients with degenerative mitral insufficiency due to ruptured or elongated chordae in the posterior leaflet underwent repair with this technique. The mean patient age was 60.4 years and 60.9% patients were male. According to clinical evaluation, 29.3% of the patients were in New York Heart Association functional class IV, 55.7% in class III and 15.0% in class II. Associated techniques of mitral valve repair were used in 15.2% of the patients; the most common was chordal shortening. Twenty six (19.5%) patients had associated procedures. There was one (0.75%) operative death. In the late postoperative period, 95.5% of the surviving patients were in New York Heart Association functional class I. Linearized rates of thromboembolism, reoperation and death were 0.9%, 0.3% and 0.6% patient/year, respectively. The actuarial survival at 10 years was 94.7% +/- 3.6%. Actuarial freedom from thromboembolism and reoperation were 97.3 +/- 1.5% and 99.2 +/-0.8%, respectively. There were no episodes of hemolysis or endocarditis. Mitral valve repair with "Double Teflon" technique presents low morbimorbidity and good clinical late evolution.
    Brazilian Journal of Cardiovascular Surgery 01/2008; 22(4):448-53.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To describe the experience with the technique of posterior leaflet extension in children suffering of rheumatic mitral regurgitation. Between April 2002, and October 2007, 30 children, mean age 11.3 years, underwent correction of mitral insufficiency with the technique of posterior leaflet extension with a pericardial patch. Eight also received a Carpentier ring. Six children had aortic valve disease and were submitted to Ross operation (five cases) or valve replacement with an aortic homograft. All were in functional class III or IV (NYHA classification). There was one death. One child presented severe hemolysis in the postoperative period and was submitted to mitral valve replacement. Clinical evolution in the remaining patients was good. Posterior leaflet extension of the mitral valve seems to be an effective surgical technique for correction of rheumatic mitral insufficiency in children.
    Brazilian Journal of Cardiovascular Surgery 12/2009; 24(4):567-9.