Minimally Invasive Nonresectional Chordal Foldoplasty For Redundant Posterior Mitral Valve Prolapse

Author Block: Peng Teng, Haige Zhao.

The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Abstract:

BACKGROUND: For redundant posterior mitral prolapse, quadrangular resection with sliding leaflet technique or butterfly resection is

warranted, which is somewhat complicated and time consuming. We proposed a novel repair technique, which called nonresectional chordal

foldoplasty, for redundant posterior leaflet prolapse, and evaluated the safety and e"cacy of this novel technique in this study.

METHODS: From November 2020 to September 2024, 80 consecutive patients undergoing minimally invasive mitral valve repair using the

novel technique for redundant mitral valve leaflet prolapse were included. The clinical data were collected from their electronic medical

records and the di#erence of preoperative, postoperative and follow-up echocardiographic data were compared.

RESULTS: The mitral regurgitation grade significantly reduced postoperatively (p<0.001) and at follow-up (p<0.001) compared with that in

the preoperative status, and there was no significant di#erence of mitral regurgitation grade between the postoperative and follow-up stages

(p=0.083). Additionally, there was a significant decrease in left ventricular dimensions postoperatively. Furthermore, none of the

echocardiographic parameters’ values at the last follow-up were significantly di#erent from their postoperative values. Nonetheless,

compared with the preoperative values, they were significantly lower. Left ventricular ejection fraction significantly decreased postoperatively

(p<0.001), but at the last follow-up no significant improvement (p=0.631) was observed and it did not reach the baseline level (p<0.001).

CONCLUSIONS:This study showed that our novel mitral valve repair technique for redundant mitral valve leaflet prolapse was safe, e#ective,

and easy to replicate, and resulted in excellent early outcomes.