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Early and mid-term results of mitral valve repair using premeasured Gore-Tex loops (‘loop technique’)

Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany

Received 5 September 2007; received in revised form 26 December 2007; accepted 4 January 2008.

^_* Corresponding author. Tel.: +49 170 935 8334; fax: +49 341 865 1452. (Email: kuntze{at}web.de).

Objective: Mitral valve (MV) repair with premeasured Gore-Tex loops (the ‘loop technique’) was introduced in 1999. We assessed the early- and mid-term outcomes for the loop technique in patients with MV prolapse. Methods: A total of 632 patients (447 male, 185 female) underwent MV repair with Gore-Tex loops for MV prolapse. A mini-thoracotomy was performed in 522 patients (mean age 58 ± 12.4 years) and 110 patients received a full sternotomy (mean age 66.5 ± 11.9 years). Early postoperative echo was performed in all patients and clinical follow-up was obtained in 95% of patients. Results: Loops were used to correct prolapse of the posterior leaflet in 308 patients, the anterior leaflet in 150 patients, and both leaflets in 174 patients. The mean length of Gore-Tex loops was 20.8 ± 3.4 mm for the A2 segment and 14.3 ± 3.0 mm for the P2 segment. Concomitant procedures consisted of atrial fibrillation ablation in 123 patients, tricuspid valve repair in 30 patients, coronary bypass surgery in 73 patients, and aortic valve surgery in 21 patients. Mean aortic cross-clamp and cardiopulmonary bypass times were 89 ± 32 and 137 ± 43 min, respectively. Predischarge echocardiography revealed no residual mitral regurgitation (MR) in 75%, trace or mild MR in 21% and mild-to-moderate MR in 4% of patients. Thirty-day survival was 98.6%, and one-year survival was 97.1%. Freedom from reoperation was 97.4 ± 1.4%, 3 years postoperatively. Conclusion: MV repair with premeasured Gore-Tex loops results in excellent early- and mid-term outcomes for all types of leaflet prolapse. The loop technique facilitates minimal invasive MV repair without compromising surgical outcomes.

Key Words: Mitral valve repair • Chordae replacement • Gore-Tex loops

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