Posterior mitral leaflet repair with a simple segmental annulus support: the 'double-Teflon technique'.
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.
- SourceAvailable from: Carlos Manuel de Almeida Brandão[Show abstract] [Hide abstract]
ABSTRACT: Objective: The purpose of this study is to present the immediate and long-term results of mitral valve repair using the double Teflon technique in patients with mitral insufficiency due to myxomatous disease and severely calcified annuli. Method: Between 1985 and 2002, 162 patients with mitral valve insufficiency due to myxomatous degeneration were submitted to mitral valve repair in the Heart Institute of University of São Paulo Medical School. From these, 13 presented severely calcified annuli and underwent mitral valve repair with quadrangular resection and annuloplasty using the double Teflon technique. The mean patient age was 65.4 ± 12.9 years with 69.2% of the patients being male. One (7.7%) patient had associated coronary artery disease and was submitted to coronary artery bypass grafting. In the preoperative period, 15.4% of the patients were in functional class IV of the New York Heart Association, 69.2% in class III and 15.4% in class II. Results: There were no operative deaths. In late postoperative period 90.9% of the surviving patients were in functional class I. There were no episodes of hemolysis or endocarditis. One patient was reoperated in the second postoperative month and was submitted to mitral valve replacement. The actuarial survival at 14 years was 71.4% ± 17.1%. Conclusions: Mitral valve repair using the double Teflon technique in patients with myxomatous disease and severely calcified annuli presented satisfactory survival rates and good clinical evolution which proved to be a better alternative than mitral valve replacement. Descriptors: Mitral valve insufficiency, surgery. Mitral valve, surgery. Heart valves, surgery. Calcinosis. Plástica valvar mitral pela técnica de "Duplo Teflon" em pacientes com anel valvar calcificado e degeneração mixomatosaBrazilian Journal of Cardiovascular Surgery 01/2005; 20(2).
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ABSTRACT: Objective: To describe the experience with the technique of posterior leaflet extension in children suffering of rheumatic mitral regurgitation.
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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.