Mid-term outcomes of non-resectional chordal foldoplasty for degenerative mitral regurgitation

OBJECTIVES: We aimed to evaluate the mid-term clinical and echocardiographic outcomes of chordal foldoplasty performed for non-resectional mitral valve repair in degenerative mitral valve disease with a large posterior leaflet. METHODS: We reviewed 82 patients undergoing non-resectional mitral valve repair via chordal foldoplasty between October 2013 and June 2021. We analysed operative outcomes, mid-term survival rate, freedom from reoperation and freedom from recurrent moderate or severe mitral regurgitation (MR). RESULTS: The mean age of patients was 57.2 ± 12.4 years; 61 patients (74%) had posterior leaflet prolapse, 21 patients (26%) had bileaflet prolapse and all of them had at least 1 tall posterior leaflet scallop. Minimally invasive approach with a right mini-thoracotomy was used in 73 patients (89%). The operative mortality was zero. There was no conversion to mitral valve replacement and postoperative echocardiography revealed no more than mild residual regurgitation or systolic anterior motion. Five-year survival rate, freedom from mitral reoperation and freedom from recurrent moderate/severe MR were 93.9%, 97.4% and 94.5%, respectively. CONCLUSIONS: Non-resectional chordal foldoplasty is a simple and effective repair technique for select degenerative MR cases with a tall posterior leaflet.