• Yeow Leng Chua, Philip Y K Pang, Yen Ping Yap, Zakir Hussain Abdul Salam, and Yang Tian Chen.
• Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore.
• Ann Thorac Cardiovasc Surg. 2016 Jan 1; 22 (2): 90-7.

ObjectiveTo review our experience of mitral valve repair for degenerative posterior mitral leaflet prolapse, comparing the outcomes of chordal reconstruction and leaflet resection.MethodsFrom 2000 to 2014, 205 patients underwent successful repair for degenerative posterior mitral leaflet prolapse. One hundred and four (51.5%) underwent leaflet resection (group R) and 98 (48.5%) underwent chordal reconstruction (group C). Follow-up was 96.5% complete with a mean follow-up of 6.1 ± 4.0 years.ResultsMean age was 57.0 ± 11.0 years. Males accounted for 73.8%. Ring annuloplasty was performed in 195 (96.5%). There were no operative mortalities within 30 days. Overall survival was 97.8% ± 1.3% at 7 years. Outcomes at 6 years: freedom from severe mitral regurgitation (group R 97.1% ± 2.0%, group C 100%, P = 0.288), freedom from moderate or severe mitral regurgitation (group R 97.1% ± 2.0%, group C 94.4% ± 5.4%, P = 0.541). Group C patients received larger annuloplasty rings and had significantly lower postoperative transmitral gradients.ConclusionsLeaflet resection and chordal reconstruction are effective techniques for repair of degenerative posterior mitral leaflet prolapse. Both techniques result in a low incidence of recurrent mitral regurgitation. Chordal reconstruction accommodates larger annuloplasty rings and is associated with lower transmitral gradients.

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