Análisis comparativo de los resultados del uso de neocuerdas frente a la resección de velo posterior en la cirugía reparadora de la insuficiencia mitral degenerativa

Abstract

Introduction and objectivesThere is a lack of studies comparing the results of both techniques in MV repair procedures for correction of posterior leaflet prolapse in degenerative mitral regurgitation and most of what has been published analyses the short term postoperative course.The present study was carried out to evaluate results of mitral valve repair surgery with quadrangular resection or neochordae implantation in degenerative posterior leaflet prolapse, with a special emphasis in postoperative leaflet coaptation analysis using the coaptation length index. Methods98 patients were included in this study if they presented degenerative posterior leaflet prolapse as the main cause of mitral regurgitation, and received quadrangular resection or neochordae implantation for its correction. We compared clinical and echocardiographic follow-up data between both techniques. ResultsPerioperatively, there were no differences in surgical times, size of ring employed, risk of systolic anterior motion and residual intraoperative mitral regurgitation. During follow-up, there were no differences in clinical course or echocardiographic examination, except for the left ventricle end-dyastolic diameter, which had a statistically better regression in the resection sample (–12.3±8.7 vs –8.1±8.5mm, P<.05). The coaptation analysis was similar for both groups (coaptation length index: 0.25±0.15 for resection group vs 0.2±0.07 for neochordae, P=.08). ConclusionsOur results demonstrate that neochordae implantation technique for degenerative posterior mitral leaflet prolapse correction offers similar mid-term clinical and echocardiographic outcomes compared to quadrangular resection technique, including the grade of leaflet coaptation.