The double-orifice technique in mitral valve repair: A simple solution forcomplex problems

Objective: The aim of this study is to report our results with the central double-orifice technique used for the treatment of complex mitral valve les ions. Methods: The central double-orifice repair has been used in 260 patients (m ean age, 56 +/- 14.3 years) over a period of 7 years. The mechanism respons ible for mitral regurgitation was prolapse of both leaflets in 148 patients , prolapse of the anterior leaflet in 68, prolapse of the posterior leaflet with annular calcification or other unfavorable features in 31, and lack o f leaflet coaptation for restricted motion or erosion of the free edge in 1 3. Degenerative disease was the cause of mitral regurgitation in 80.8% of t he patients, rheumatic disease was the cause in 9.6%, endocarditis was the cause in 6.1%, and ischemic disease was the cause in 2.3%. Results: Hospital mortality was 0.7%, and the overall survival at 5 years w as 94.4% +/- 2.59%. Thirteen patients required a reoperation (2 early posto peratively and 11 late during the follow-up), for an overall freedom from r eoperation of 90.0% +/- 3.37% at 5 years. Freedom from reoperation was lowe r in patients with rheumatic valve disease and in patients who did not unde rgo an annuloplasty procedure. Conclusions: The effectiveness and durability of the central double-orifice technique were assessed in this study. This type of repair can be a useful addition to the surgical armamentarium in mitral valve reconstruction.