Title: Assessment of efficacy of surgical anterior mitral leaflet plasty in adults with primum-type atrial septal defect
- Karol Bartczak, Ryszard Jaszewski, Marian Zwoliński, Alicja Iwaszkiewicz, Anna Kośmider, Andrzej Walczak, Sławomir Jander, Janusz Zasłonka
- Original articles
- Polish Journal of Cardiology
- Start page:
- Final page:
- ostium primum atrium septal defect, anterior leaflet plasty, adults
Aim: Aim of the study was to assess the efficacy of anterior mitral leaflet plasty in adult patients operated upon due to primum-type atrial septal defect (ASD I).
Material and methods: Between 1988 and 1998, 16 patients with ASD I associated with mitral incompetence due to cleft anterior mitral leaflet were operated upon in the Department of Cardiac Surgery, Institute of Car-diology, Medical University of Łódź (10 men and 6 women agedfrom 18to58years, mean 36 years). The patients were referred to the surgery after clinical examination and echocardiographic assessment inclu-ding transthoracic and transesophageal study. Mitral incompetence was quantified using a four grade scalę. Additionally, in 8 patients cardiac cathaterization was performed in order to assess precisely pulmonary artery pressure. All of the patients were operated upon on cardiopulmonary bypass and the procedurę was performed through the right atriotomy. Mitral cleft was managed with interrupted prolene suture and atrial defect was closed with autologous pericardial patch. Long-term assessment was performed between 2 and 8 years, mean 5 years, postoperatively.
Results: There was no mortality in hospital an during the follow-up period. Anterior mitral leaflet plasty performed in cases with properly configurated and working subvalvular apparatus provided good hemodynamic function of the valve in 13 patients (81%). Only 3 patients (19%) reguired mitral valve replacement during follow-up period (mean 4 years after the plasty) - in 2 cases mitral lesion was caused by infective endocarditis and in one patient spontaneous significant mitral incompetence was diagnosed 2 years after the operation.
Conclusion: Finally developed mitral valve in the adults enables the efficient anterior leaflet plasty and the outcomes are better than those obtained in the younger patients.