Is Anterior Leaflet Repair Necessary in Repair of Bileaflet Mitral Valve Prolapse?
A. Marc Gillinov*, Delos M. Cosgrove, Sudhir Wahi*, William J. Stewart*, Bruce W. Lytle, Nicholas G. Smedira*, Patrick M. McCarthy, Per N. Weirup*, Joseph A. Sabik*, and Eugene H. Blackstone*, Cleveland, OH Objective: Bileaflet prolapse has traditionally been treated by posterior leaflet resection combined with one of a number of procedures designed to support the anterior mitral leaflet. However, most patients with bileaflet prolapse do not have anterior chordal pathology. This study was undertaken to evaluate the effectiveness of a strategy of posterior leaflet resection and annuloplasty alone for patients with bileaflet prolapse and no anterior chordal pathology. Patients and Methods: From 1993 to 1997, 98 patients with transesophageal echocardiography (TEE)-demonstrated bileaflet prolapse and without evidence of anterior leaflet chordal elongation or rupture had primary isolated mitral valve repair. This consisted of posterior leaflet resection (quadrangular in 33 and sliding in 65
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