Preservation of mobility of the posterior mitral leaflet after mitral valve repair with neochordae using loop technique

Hiroto Kitahara, Mitsushige Murata, Kazuma Okamoto, Mikihiko Kudou, Akihiro Yoshitake, Hikaru Tsuruta, Yuji Itabashi, Keiichi Fukuda, Ryohei Yozu, Hideyuki Shimizu

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Recently, the loop technique has been standardized for mitral valve repair, with excellent long-term outcomes reported. This study thus analyzed whether the loop technique could preserve mitral leaflet mobility on trans-thoracic echocardiography. Methods and Results: Among 367 concomitant patients who underwent mitral valve repair at Keio University Hospital between January 2007 and December 2014, 304 patients had a prolapse of the posterior leaflet. Of these, 84 cases assessed on echocardiography were retrospectively analyzed for this study. These patients were divided into 4 groups based on the procedure used: (1) group L1 (n=28), loop technique alone; (2) group L2 (n=14), loop technique with resection and suture; (3) group L3 (n=33), loop technique with plication of indentation; and (4) group R (n=9), resection and suture alone. The mean postoperative mobile posterior mitral leaflet (PML) angles in groups L1 and L2 (39.3±16.0°, 37.3±16.0°) were significantly larger than those in groups L3 and R (18.8±15.7°, 15.3±15.7°), respectively (P<0.01). Ring size, age, and mobile PML angle had a statistically significant correlation with the postoperative mean mitral valve pressure gradient (P<0.05). Conclusions: The loop technique preserved PML mobility and enabled implantation of a larger ring, resulting in a reduced mean mitral valve pressure gradient.

Original languageEnglish
Pages (from-to)663-667
Number of pages5
JournalCirculation Journal
Issue number3
Publication statusPublished - 2016 Feb 25


  • Leaflet mobility
  • Loop technique
  • Mitral valve repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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