HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nawwar Al Attar Alberto Tripodi Arrigo Lessana Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mascagni, R. Articles by Lessana, A. Search for Related Content PubMed PubMed Citation Articles by Mascagni, R. Articles by Lessana, A. Related Collections Valve disease

Ann Thorac Surg 2005;79:471-473
© 2005 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Edge-to-Edge Technique to Treat Post-Mitral Valve Repair Systolic Anterior Motion and Left Ventricular Outflow Tract Obstruction

^a Department of Cardiac Surgery and Cardiology, Villa Maria Cecilia Hospital, Cotignola (RA), Italy
^b Department of Cardiac Surgery of the Centre Cardiologique du Nord, Saint DenisVilla Maria Cecilia Hospital
^c Department of Anesthesia and Critical Care Medicine, Lariboisiere Hospital, Paris, France

Accepted for publication August 3, 2004.

^* Address reprint requests to Dr Lessana, Centre Cardiologique du Nord, Département de Chirurgie Cardiaque, 32–36 rue des Moulins Gémeaux, St. Denis 93200, France (E-mail: a.lessana{at}wanadoo.fr).

BACKGROUND: Systolic anterior motion of the mitral valve causing left ventricular outflow tract obstruction is an uncommon complication of mitral valve repair that may necessitate immediate additional surgical action. We prospectively evaluated the technique of the edge-to-edge suture on post-mitral repair systolic anterior motion, which persisted despite conservative treatment.

METHODS: From March 2002 to March 2004, 4 of 112 patients requiring mitral valve repair surgery for chronic degenerative mitral regurgitation had systolic anterior motion with severe left ventricular outflow tract obstruction and mitral regurgitation. All 4 patients (mean age, 50 years) had posterior leaflet prolapse with chordal rupture with a billowing anterior leaflet, but without chordal rupture. Repair was achieved through a quadrangular resection of the posterior leaflet, completed by plication of the annulus in 2 patients and leaflet sliding in the other 2. All patients had mitral annuloplasty; two patients had a complete CE Physio ring (Edwards Lifesciences, Irvine, CA) inserted, whereas the other 2 patients had an open CG Future band (Medtronic, Minneapolis, MN). Routine perioperative transesophageal echocardiography showed systolic anterior motion, severe left ventricular outflow tract obstruction (> 50 mm Hg), and mitral regurgitation. After resuming cardiopulmonary bypass, all patients had an edge-to-edge suture at the middle part of the free edge of the anterior and posterior leaflets.

RESULTS: The control transesophageal echocardiography showed in all cases disappearance of the systolic anterior motion, of the left ventricular outflow tract obstruction and of mitral regurgitation. Mean follow-up was 14 months (range, 6 to 28 months). All patients were in New York Heart Association's functional class I.

CONCLUSIONS: With the edge-to-edge repair, the early and 2-year results were satisfactory with total disappearance of the systolic anterior motion, of the left ventricular outflow tract obstruction and of the recurrent mitral regurgitation.

This article has been cited by other articles:

				P.M. McCarthy, E.C. McGee, V.H. Rigolin, Q. Zhao, H. Subacius, A.L. Huskin, S. Underwood, B.J. Kane, I. Mikati, G. Gang, et al. Initial clinical experience with Myxo-ETlogix mitral valve repair ring J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 73 - 81. [Abstract] [Full Text] [PDF]

				P. W.M. Fedak, P. M. McCarthy, and R. O. Bonow Evolving Concepts and Technologies in Mitral Valve Repair Circulation, February 19, 2008; 117(7): 963 - 974. [Full Text] [PDF]

				M. Enriquez-Sarano, V. T. Nkomo, and H. Michelena Principles and Practice of Echocardiography in Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 315 - 348. [Full Text]

				M. L. Brown, M. D. Abel, R. L. Click, R. G. Morford, J. A. Dearani, T. M. Sundt, T. A. Orszulak, and H. V. Schaff Systolic anterior motion after mitral valve repair: Is surgical intervention necessary? J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 136 - 143. [Abstract] [Full Text] [PDF]

				D. H. Adams, A. C. Anyanwu, P. B. Rahmanian, V. Abascal, S. P. Salzberg, and F. Filsoufi Large Annuloplasty Rings Facilitate Mitral Valve Repair in Barlow's Disease Ann. Thorac. Surg., December 1, 2006; 82(6): 2096 - 2101. [Abstract] [Full Text] [PDF]

				M. Basaran, O. Selimoglu, T. Yildirim, and N. Temucin Ogus Use of Alfieri stitch technique in a patient with hypertrophic obstructive cardiomyopathy Interactive CardioVascular and Thoracic Surgery, December 1, 2006; 5(6): 738 - 739. [Abstract] [Full Text] [PDF]

				D. R. Brinster, D. Unic, M. N. D'Ambra, N. Nathan, and L. H. Cohn Midterm Results of the Edge-to-Edge Technique for Complex Mitral Valve Repair. Ann. Thorac. Surg., May 1, 2006; 81(5): 1612 - 1617. [Abstract] [Full Text] [PDF]

				Y.-Q. Lai, Y. Luo, C. Zhang, and Z.-G. Zhang Utilization of Double-Orifice Valve Plasty in Correction of Atrioventricular Septal Defect Ann. Thorac. Surg., April 1, 2006; 81(4): 1450 - 1454. [Abstract] [Full Text] [PDF]

				T. E. David, J. Ivanov, S. Armstrong, D. Christie, and H. Rakowski A comparison of outcomes of mitral valve repair for degenerative disease with posterior, anterior, and bileaflet prolapse J. Thorac. Cardiovasc. Surg., November 1, 2005; 130(5): 1242 - 1249. [Abstract] [Full Text] [PDF]