Clinical Analysis Of Valvuloplasty For Degenerative Anterior Leaflet Prolapse

ObjectiveTo summarize the experiences and analyze the short-term and mid-term results of mitral valvuloplasty in treating degenerative anterior leaflet prolapse.MethodsFrom April 2009 to November 2018,65 patients with degenerative anterior leaflet prolapse underwent mitral valvuloplasty in our department.There were 36 male and 29 female with age(51.1±16.6)years old.4 patients were in New Yoke Heart Association(NYHA)class I,10 in Class II,10 in class III and 5 in class IV preoperatively.Echocardiography before operation showed the degree of mitral regurgitation was severe in 48 and moderate in 17 patients.All patients underwent mitral valve repair under standard cardiopulmonary bypass.Surgical procedures included artificial chordal replacement,edge to edge leaflet suture,artificial valve ring implantation,valve leaflets excision,valve defects repair.Saline injection test and transesophageal echocardiography were used to assess the results of mitral valvuloplasty.Postoperative echocardiography was used for follow-up.ResultsDuring the operation,transesophageal echocardiography and saline injection test showed satisfying results.1 patient died of heart failure during the perioperative period.The follow-up time range from 6months to 9.2 years.During the follow up,41 patients were in New Yoke Heart Association(NYHA)class I,8 in Class II,2 in class III and 1 in class IV.The Echocardiography showed that postoperative left atrium diameter(38.6 ± 7.7 mm vs.46.7 ± 7.5 mm,P=0.000)and left ventricular end-diastolic dimension(47.1 ± 7.2 mm vs.56.4 ± 7.5 mm,P=0.000)were significantly smaller than that before operation.No or trace mitral regurgitation(MR)was found in 40 patients,mild MR in 8 patients,moderate MR in 2patients,and severe MR in 2 patients.Mitral valve replacement was performed in 1patients a year after valvuloplasty.1 patient died of heart failure during the follow-up.ConclusionsThe short-term and mid-term results of mitral valve repair for degenerative anterior leaflet prolapse are satisfactory if appropriate surgical methods are chosen.The effect of mitral valvuloplasty can be confirmed by transesophageal echocardiography and saline injection test.