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Khramchenkov A.G.

Bakulev National Medical Research Center of Cardiovascular Surgery

Sachkov A.S.

Bakulev National Medical Research Center of Cardiovascular Surgery

Titov D.A.

Bakulev Research Center for Cardiovascular Surgery

Soboleva N.N.

Bakulev National Medical Research Center of Cardiovascular Surgery

Babenko S.I.

Bakulev National Medical Research Center of Cardiovascular Surgery

Muratov R.M.

Bakulev Research Center for Cardiovascular Surgery

Transverse posterior mitral leaflet folding for mitral valve prolapse: surgical technique and outcomes

Authors:

Khramchenkov A.G., Sachkov A.S., Titov D.A., Soboleva N.N., Babenko S.I., Muratov R.M.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(4): 420‑427

DOI: 10.17116/kardio202417041420

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Table of contents

TRANSVERSE POSTERIOR MITRAL LEAFLET FOLDING FOR MITRAL VALVE PROLAPSE: SURGICAL TECHNIQUE AND OUTCOMES
TRANSVERSE POSTERIOR MITRAL LEAFLET FOLDING FOR MITRAL VALVE PROLAPSE: SURGICAL TECHNIQUE AND OUTCOMES

To cite this article:

Khramchenkov AG, Sachkov AS, Titov DA, Soboleva NN, Babenko SI, Muratov RM. Transverse posterior mitral leaflet folding for mitral valve prolapse: surgical technique and outcomes. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(4):420‑427. (In Russ.)
https://doi.org/10.17116/kardio202417041420

 
ЭндоКард
Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)
 
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To evaluate the long-term results of transverse posterior mitral leaflet folding for mitral valve prolapse.

MATERIAL AND METHODS

Forty-nine patients underwent mitral valve repair between September 2013 and August 2022. All patients had posterior mitral leaflet prolapse in one segment. The sample included 26 men and 23 women, mean age — 57±12 years. All ones had LV enlargement (end-diastolic volume (EDV) 182±50 ml) and satisfactory left ventricular contractility (ejection fraction (EF) 67±7%). After assessing the mitral valve we invaginated the prolapsed segment of posterior leaflet into the left ventricle with subsequent interrupted polypropylene sutures. After that, ring annuloplasty was performed.

RESULTS

One patient died in 23 days after surgery due to stroke. In 5 cases, we intraoperatively observed severe residual mitral regurgitation that required additional manipulations: sliding repair (n=1) and triangular resection of P2 segment due to SAM syndrome (n=1), additional Alfieri sutures (n=2), mitral valve replacement with mechanical prosthesis (n=1) because the cause of recurrent failure could not be eliminated after repeated aortic cross-clamping. Other patients were discharged with no or minimal mitral regurgitation. Mean follow-up period was 66±25 months, mortality — 4.4% (n=2). One patient died after 48 months due to stroke, 1 patient — from arrhythmia complicated by chronic heart failure. Other patients had no active complaints. LV EF was 64±4%, LV EDV — 123±23 ml. There was only 1 (2.2%) case of severe mitral regurgitation. Other patients had no or minimal mitral regurgitation. Peak and mean pressure gradients were physiological (5±1 and 3±1 mm Hg, respectively).

CONCLUSION

Transverse plication of prolapsed posterior mitral leaflet demonstrates stable immediate and long-term results. This reconstruction is easy and not irreversible. In case of intraoperative recurrence of regurgitation, this technique makes it possible to return to original state of the valve and perform other reconstructions.

Keywords:

mitral valve reconstruction
leaflet invagination

Authors:

Khramchenkov A.G.

Bakulev National Medical Research Center of Cardiovascular Surgery

Sachkov A.S.

Bakulev National Medical Research Center of Cardiovascular Surgery

Titov D.A.

Bakulev Research Center for Cardiovascular Surgery

Soboleva N.N.

Bakulev National Medical Research Center of Cardiovascular Surgery

Babenko S.I.

Bakulev National Medical Research Center of Cardiovascular Surgery

Muratov R.M.

Bakulev Research Center for Cardiovascular Surgery

Received:

15.02.2023

Accepted:

13.08.2023

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