Mitral Valve Repair in an Adult Case of Marfan's Syndrome

(Department of Cardiovascular Surgery, Shin-Koga Hospital, Kurume, Japan)

Masaru Yoshikai Junichi Murayama Keiji Kamohara
Yasushi Hisamatsu
We present a case of successful mitral valve repair in a 38-year-old woman with Marfan's syndrome. Prolapse in a redundant billowing posterior mitral leaflet caused severe mitral valve regurgitation. Only slight dilatation of the sinus Valsalva and grade I aortic regurgitation were recognized. At operation, prolapsed portions seen on both sides of the middle scallop were quadrangularly resected. The sliding leaflet technique reduced the height of the posterior mitral leaflet to prevent systolic anterior motion of the mitral valve, which could be expected to occur after the operation. The anterior extremities of the Carpentier-Edwards annuloplasty ring were bent upward to accommodate the shape of the anterior mitral leaflet. Mitral valve regurgitation disappeared postoperatively, and she is now doing well 3 years after the operation. In general, isolated mitral valve regurgitation appears in relatively young patients with Marfan's syndrome, and these patients are at high risk of developing aortic dissection and aortic regurgitation. Therefore, mitral valve repair should be performed to improve the quality of life after the operation, and to reduce the risk of bleeding, which may be a lethal complication in aortic surgery.
@Jpn. J. Cardiovasc. Surg. 33: 42 -44 (2004)