A new design for posterior leaflet resection, “butterfly resection,” is proposed. It is a combination of two triangular resections in the prolapsing posterior leaflet segment. This method minimizes resection in the target segment, and it prevents systolic anterior motion by reducing the height of the posterior leaflet according to the amount of excess tissue. We have used this technique for 60.4% (29 of 48) of posterior leaflet prolapse cases with zero hospital mortality and no morbidity. Postbypass transesophageal echocardiography identified no more than mild regurgitation and no sign of systolic anterior motion. During 13.1 ± 6.8 months of follow-up, patients neither died nor needed reoperation.
From the Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Accepted for publication December 16, 2010.
Presented at the Annual Scientific Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery, June 11–14, 2008, Boston, MA USA.
Address correspondence and reprint requests to Tohru Asai, MD, PhD, Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga 520-2192, Japan. E-mail: email@example.com–med.ac.jp.