Posterior mitral annuloplasty with a flexible linear reducer.

Abstract

We evaluated posterior annuloplasty results using a flexible linear reducer, especially as a cardiac surgical procedure. Subjects were 24 patients consisting of 20 men and 4 women aged 7 to 79 years (mean; 61.3 years) with mitral regurgitation who underwent mitral valve reconstruction using a flexible linear reducer from May 1999 to April 2001. Mitral regurgitation was attributed to myocardial ischemia in 9 (37.5%). Isolated mitral valve repair was conducted only in 3 (12.5%) and concomitant procedures in 21 (87.5%). No operative deaths occurred. One hospital death (4.2%) occurred due to cardiac failure on postoperative day 58. Four late deaths (16.7%) occurred 8 to 15 months after surgery due to heart failure, stroke, and cancer. No patients required reoperation and no perioperative complications occurred. Doppler echocardiography conducted in all patients within a month postoperatively showed excellent valve function: 11 (45.8%) had no residual regurgitation, 5 (20.8%) had trivial insufficiency, 6 (25%) had mild insufficiency, 2 (8.3%) had moderate insufficiency, and none had severe insufficiency. We observed significantly reducted enddiastolic and systolic left ventricular diameter while ejection fraction remained unchanged. Posterior mitral annuloplasty using a flexible linear reducer is simple, saves time, and is useful for the small left atrium and as an additional procedure in other cardiac surgery.