Abstract
Mitral valve repair is the treatment of choice to correct mitral insufficiency. Although the literature related to left atrial and ventricular behavior after mitral repair without use of prosthetic rings is scarce. To analyze cardiac morphology and function using real time tridimensional echocardiography in individuals submitted to mitral valve repair with Double Teflon technique. Were included 14 patients with mixomatous mitral valve insufficiency that were submitted to mitral valve repair with the Double Teflon technique. Of them, 13 patients were in class III/IV. Patients were evaluated in preoperative period, immediate postoperative period, 6 months and 1 year after mitral repair. Statistic analysis was made by repeated measures ANOVA test and was considered statistically significant P <0.05. The analysis of systolic volumes, atrial and ventricular, demonstrated a significant volumetric reduction between immediate postoperative period and 1 year (P = 0.028 and P = 0.020, respectively). Between preoperative period and 1 year, there was a mean reduction in atrial and ventricle volumes of 19.9% and 15.4%, respectively. Atrial and ventricle diastolic volumes presented a significant reduction in immediate postoperative period (P <0.001 and P = 0.024, respectively), remaining stable during the study. There was an increase in left atrial ejection fraction after 6 months (P <0.001), although there was no significant variation in left ventricle ejection fraction. Patients submitted to mitral valve repair by the Double Teflon technique demonstrated a left atrial and ventricle reverse remodeling. These reductions were associated with an improvement in left atrial function during the study.
Highlights
Mitral valve repair is the treatment of choice for mitral insufficiency, the literature is scarce regarding the behavior of the atrium and left ventricle after mitral repair without the use of prosthetic rings
Patients submitted to mitral valve repair using the Double Teflon technique showed reverse remodeling of the left atrium and left ventricle
After the study was approved by the Ethics Committee of Hospital das Clinicas, Faculty of Medicine, University of São Paulo and obtaining a written post-informed consent, between May/2006 and August/2008 we included 14 consecutive patients with mitral insufficiency secondary to mitral valve prolapse of degenerative etiology, due to elongation or tendon chordal rupture related to the mitral valve posterior cusp, who underwent mitral valve repair with the Double Teflon technique (Figure 1)
Summary
Mitral valve repair is the treatment of choice for mitral insufficiency, the literature is scarce regarding the behavior of the atrium and left ventricle after mitral repair without the use of prosthetic rings. Results: The analysis of systolic, atrial and ventricular volumes showed a significant reduction between the IPO and one year (P = 0.028 and P = 0.020, respectively). In Brazil, Pomerantzeff et al [18] developed a modified technique using wire with pledgets over Teflon flap for segmental plication of the posterior ring corresponding to the segment removed from the cusp without using prosthetic ring. This technique, called “Double Teflon technique ‘has been showing excellent long term results, with low rates of morbidity and mortality [19,20]
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