TY - JOUR AU - Ma, Kangmu AU - Chen, Anqing AU - Wang, Zhe AU - Liu, Jun AU - Zhao, Qiang PY - 2019 TI - Chordal replacement versus quadrangular resection in degenerative posterior mitral leaflet repair JF - Journal of Thoracic Disease; Vol 11, No 3 (March 29, 2019): Journal of Thoracic Disease Y2 - 2019 KW - N2 - Background: As an alternative to quadrangular resection (QR), little is known of the potential of chordal replacement (CR) for treating posterior mitral leaflet (PML) prolapse when comparing these two techniques. This study aimed to assess mid- to long-term outcomes of CR versus QR for isolated degenerative PML (idPML) repair. Methods: We reviewed 112 consecutive patients using CR or QR for idPML repair from 4/2010 to 12/2015. Outcomes were compared before and after propensity score matching. Results: CR was more used through the minimally invasive approach (CR 59.4% vs . QR 9.4%, P vs . QR 14.0±8.3 days, P vs . QR 30.8%, P (log-rank) =0.017], however QR showed better freedom from above-mild recurrent MR (MR ≥2.5+) during follow-up [60 months, CR 50.2% vs . QR 96.3%, P (log-rank) =0.061]. Cox regression analysis might suggest that CR technique was a risk factor for recurrent MR [CR over QR, hazard ratio (HR) 2.149; 95% CI: 0.974–4.744; P=0.058; adjusted for surgical approach, gender, age, preoperative MR and ejection factor (EF)]. Conclusions: CR is more often used with the minimally invasive approach with less complications and shorter hospital stay. Nonetheless, CR is associated with recurrent MR development over time. Retaining of MV competence after CR demands attention and further investigation. UR - https://jtd.amegroups.org/article/view/27221