The aim of our study was to evaluate: a) the clinical manifestations in patients with mitral valve prolapse undergoing surgical repair; b) the pre- and intraoperative echocardiographic features in these patients; c) whether clinical and echocardiographic data may predict the surgical outcome. Sixty-one patients were evaluated by transthoracic (TTE) and multiplane transesophageal echocardiography (TEE). In 10 patients (16%) there was a wide billowing of both mitral leaflets, with persistent coaptation; 5 patients (8%) had flail of the anterior mitral leaflet and 46 patients (75%) had flail of the posterior mitral leaflet. Fifty-one patients had chordal rupture, as documented by multiplane TEE and confirmed by the surgeon. Mitral annulus diameter was enlarged (4.2 ± 0.5 cm); lengthening of the anterior mitral leaflet (mean value 3.19 ± 0.37 cm) and thickening of both valvular leaflets (anterior mitral leaflet 3 ± 0.37 mm; posterior mitral leaflet 2.91 ± 0.68 mm) were also observed. On the basis of the TTE and multiplane TEE evaluation, mitral valve replacement was electively performed in 7 patients; 54 patients underwent mitral repair. In 5 cases residual mitral regurgitation (3+) and in 1 case mitral stenosis were documented by intraoperative multiplane TEE and these patients (11%) underwent valve replacement. There was no intraoperative death; one patient in NYHA functional class IV died 15 days after operation. In conclusion, in patients with organic mitral valve prolapse and severe regurgitation undergoing valve repair TTE and multiplane TEE are an accurate tool to examine valvular anatomy and to assist the surgeon in planning the operation and evaluating its results. The majority of patients has chordal rupture of posterior mitral leaflet, a condition associated with excellent results of valve repair.
|Number of pages||4|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging