Surgical techniques:
Surgery was performed with use of cardiopulmonary bypass using cold
crystalloid cardioplegic arrest. Bicaval cannulation was used and
exposition of the mitral valve was achieved via a bi-atrial vertical
transseptal incision or via Waterston’s incision. Moderate hypothermia
(32–34°C) was used. In the repair group, the valve was corrected using
the “respect” technique by insertion of 2–5 artificial Gore-Tex
Neo-Chordae to re-suspend the prolapsing segments in the presence of
chordal rupture or elongation, in addition to a supplement of remodeling
annuloplasty. Neo-Chordae were used via a premeasured moveable loop
technique (12) with ventricular placed knots. In forms of regurgitation
not associated with chordal rupture or elongation, correction of MV was
performed only by remodeling annuloplasty. The rings used were
Carpentier Edwards Physio II Annuloplasty ring or Sorin Memo 3D ReChord
Mitral Valve Annuloplasty ring. In select cases, cleft sutures were
placed.