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.