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

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 mate, 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 atria[ 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. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.