Mitral Valve Repair for Patients with Mitral Valve Prolapse

Prosthetic valve replacement has mainly been performed on patients with mitral regurgitation. In such cases, prosthetic valve related complications, such as thromboembolism, bleeding, prosthetic valve infection, and structural valve deterioration, are unavoidable. With valve plasty, however, not only can such complications be avoided, but patients can also have as good a quality of life as healthy people without medications. Although mitral valve plasty requires complicated techniques like chordal reconstruction and has problems of residue, recurrence, and progression of regurgitation, patients with mitral valve prolapse are considered to be good candidates for this procedure. Mitral annuloplasty with a prosthetic ring is the essential and basic procedure of this operation, usually adding to the other techniques. Resection and suture methods of quadrangular resection, triangular resection and the sliding method, by which systolic anterior movement can be avoided, are indicated for patients with posterior leaflets prolapse. The resection and suture method, chordal shortening, and chordal transposition were previously done on patients with anterior leaflets prolapse, but recently chordal reconstruction using ePTFE (expanded polytetrafluoroethylene) is performed. Superior long-term results of mitral valve plasty for patients with mitral valve prolapse compared to prosthetic valve replacement have been reported. The 10-year reoperation rate of mitral valve plasty is only 7-10% as much as valve replacement.