• Antonio M Calafiore, Angela L Iacò, Adam Ibrahim, Hussein Al-Amri, Reda Refaie, Ali Own, El Shurafa Heytham, and Michele Di Mauro.
• Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. Electronic address: am.calafiore@gmail.com.
• J. Thorac. Cardiovasc. Surg.. 2014 Oct 1;148(4):1407-1412.e1.

ObjectiveThe study objective was to evaluate the midterm results of a technique for correction of posterior leaflet prolapse without resection or use of artificial chordae.MethodsFrom May 2009 to October 2013, 96 patients with isolated posterior leaflet prolapse (n=36) or bileaflet prolapse (n=60) with or without chordal rupture underwent posterior leaflet repair at the Prince Sultan Cardiac Center. The novel Uniscallop ("U") technique was used in 46 patients (group U), based only on scallop suture without resection or artificial chordae application. A conventional approach (quadrangular or triangular resection, focal sliding, artificial chordae) was adopted in the remaining 50 patients (group C). In both groups, the annulus was reshaped using a 40- or 50-mm-long band. Postoperative echocardiography was performed in all patients after a mean follow-up of 18±13 months in group U and 20±9 months in group C.ResultsThere were no early or late deaths. No patients in either group showed systolic anterior motion. Both surgical strategies were successful in obtaining a significant reduction in mitral regurgitation grade. Left ventricular function was maintained, and tricuspid regurgitation grade was reduced overall. Moderate mitral regurgitation during follow-up developed in only 1 patient in group C, as the result of dehiscence of a plication stitch.ConclusionsAlthough the rationale for the use of the U technique is different from what is generally accepted, the midterm results of this approach are comparable to those obtained with more conventional techniques, remaining stable after a mean follow-up of 18 months.Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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