Edge-to-edge technique to repair mitral commissural prolapse.

Objective: Repair for mitral commissural prolapse can represent a challenging surgical problem. Although there are various reports of repair for mitral commissural prolapse, the technique is not necessarily simple. There are few reports of repair by the edge-to-edge suture for commissural prolapse, and the results are not entirely clarified. We report the application and early and intermediate outcome of this technique for mitral commissural prolapse.

Methods: From January 1999 to April 2005, a total of 12 patients with commissural prolapse due to degenerative disease were operated on using the edge-to-edge technique. The patients were seven men and five women with a mean age of 48.5 years. The mechanism of the regurgitation was chordal rupture in nine patients and chordal elongation in three patients.

Results: There were no in-hospital deaths or complications. Postoperative echocardiography demonstrated that regurgitation had disappeared in nine patients, was trivial in two patients, and was mild in one patient. During the follow-up period (mean 49.8 +/- 22.0 months) all patients lived vigorously, and no recurrence or aggravation of regurgitation or valve-related complications were observed.

Conclusions: It seems that the edge-to-edge technique for mitral commissural prolapse due to degenerative disease is a technically simple, highly effective procedure.