Early and follow-up results of butterfly resection of prolapsed posterior leaflet in 76 consecutive patients

Objective: The present study aims to examine the medium-term results of butterfly resection. Methods: Of 587 consecutive patients who underwent surgery for mitral regurgitation between January 2002 and August 2012, 162 patients underwent valve reconstruction of a prolapsed posterior leaflet. Quadrangular resection (n = 50, Quadrangular group) was primarily used before November 2006 (when we innovated the concept of butterfly resection). After that, we mainly used butterfly resection (n = 76, Butterfly group). Results: Although there was no sign of systolic anterior motion in the Butterfly group, it occurred in 2 patients in the Quadrangular group. One patient in the Quadrangular group died of stroke at postoperative day 17. The mean follow-up period was 2.2 +/- 1.6 years for the Butterfly group and 6.1 +/- 2.5 years for the Quadrangular group. During those periods, 2 patients died of noncardiac causes in the Butterfly group and 1 patient died of an unknown cause in the Quadrangular group. One patient in the Quadrangular group required a reoperation for recurrent mitral regurgitation arising from a new lesion of the anterior leaflet. One patient in the Butterfly group required a reoperation for partial dehiscence of suture at the posterior leaflet. The 3-year estimated survivals free from overall death and reoperation for recurrent mitral regurgitation in the Butterfly group and the Quadrangular group were 97% +/- 2% versus 96% +/- 3% (P =.89) and 95% +/- 3% versus 96% +/- 3% (P =.75), respectively. Conclusions: Butterfly resection provides acceptable early and medium-term results.