초록접수 현황
| 15F-182 | 구연 발표 |
Posterior Mitral Annuloplasty for Enhancing Mitral Leaflet Coaptation: Technical Benefits and the Midterm Results
김종헌, 송준영, 김경화, 최종범, 구자홍
전북대학교 의학전문대학원 전북대학교병원 흉부외과학교실
Background : In patients with moderate to severe mitral valve regurgitation (MR), posterior mitral annuloplasty (PMA) was performed as the last procedure for mitral valve repair using a strip designed for placement in the posterior annulus, sparing the anterior annulus and both commissures. We evaluated the midterm results of the PMA using the strip.
Methods : Between September 2009 and August 2014, we performed PMA using a PMA strip in 82 consecutive patients (male, 50%; mean, 61.6 ± 13.9 years) with greater than moderate to severe MR. Procedures associated with the PMA for mitral valve repair were performed in 47 patients (57.3%), including new chord placement for leaflet prolapse (n=35), patch valvuloplasty for posterior chord rupture (n=7), and posterior leaflet augmentation (n=15). All patients were analyzed by serial echocardiographic follow-up.
Results : At a mean follow-up of 42.4 ± 17.1 months, the MR grade was nil or mild (0 and 1+) in 71 patients (86.6%), moderate (2+) in 10 patients (12.2%), and moderate to severe (3+) in 1 patient (1.2%). The mean indexed valve area and mean valve gradient were 1.7 ± 0.4 cm²/M² and 3.4 ± 1.2 mmHg, respectively. None of the patients with remnant or recurrent MR experienced hemolysis. During the cardiac cycle, the repaired valves exhibited dynamic changes in the septo-lateral dimensions. No early conversions occurred to valve replacements or late reoperations.
Conclusion : The results indicate that the PMA technique using the characteristically designed strip is a reliable alternative annuloplasty technique with rare recurrent regurgitation and no relevant complications.
Methods : Between September 2009 and August 2014, we performed PMA using a PMA strip in 82 consecutive patients (male, 50%; mean, 61.6 ± 13.9 years) with greater than moderate to severe MR. Procedures associated with the PMA for mitral valve repair were performed in 47 patients (57.3%), including new chord placement for leaflet prolapse (n=35), patch valvuloplasty for posterior chord rupture (n=7), and posterior leaflet augmentation (n=15). All patients were analyzed by serial echocardiographic follow-up.
Results : At a mean follow-up of 42.4 ± 17.1 months, the MR grade was nil or mild (0 and 1+) in 71 patients (86.6%), moderate (2+) in 10 patients (12.2%), and moderate to severe (3+) in 1 patient (1.2%). The mean indexed valve area and mean valve gradient were 1.7 ± 0.4 cm²/M² and 3.4 ± 1.2 mmHg, respectively. None of the patients with remnant or recurrent MR experienced hemolysis. During the cardiac cycle, the repaired valves exhibited dynamic changes in the septo-lateral dimensions. No early conversions occurred to valve replacements or late reoperations.
Conclusion : The results indicate that the PMA technique using the characteristically designed strip is a reliable alternative annuloplasty technique with rare recurrent regurgitation and no relevant complications.
책임저자: 최종범
전북대학교 의학전문대학원 전북대학교병원 흉부외과학교실
연락처 : 김종헌, Tel: 063-250-1480 , E-mail : kim77jh@gmail.com
