Minimally invasive mitral valve repair using artificial chordae via right mini‐thoracotomy: a single-center experience

MP032 

Abstract Submission 

Vinh D.A. Bui (1), Dinh Nguyen (2), Dang Nguyen (3), ALEJANDRO PIZANO (4), Heath Rutledge-Jukes (5), Chuong Pham (6), Thuan Phan Quang (6), Nam Nguyen (7), Dominique Vervoort (8), Phu Bui (9)

(1) Department of Thoracic and Cardiovascular Surgery, Hue Central Hospital, Hue, Viet Nam, (2) University Medical Center Ho Chi Minh City; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam, (3) Department of Biomedical Engineering, University of South Florida, Tampa, FL, USA, (4) University of Texas Southwestern, Dallas, TX, USA, (5) Washington University in St. Louis School of Medicine; Centaur Labs Inc; King of the Curve LLC, Saint Louis, MO, USA, (6) Department of Adult Cardiovascular Surgery, University Medical Center Ho Chi Minh City, Ho Chi Minh, Viet Nam, (7) University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam, (8) Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada, (9) College of Health Sciences, VinUniversity, Ha Noi, Viet Nam

Vinh D.A. Bui    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Hue Central Hospital

Dinh Hoang Nguyen    -  Contact Me
University Medical Center Ho Chi Minh City; University of Medicine and Pharmacy at Ho Chi Minh City

Dang Nguyen    -  Contact Me
Department of Biomedical Engineering, University of South Florida

ALEJANDRO PIZANO    -  Contact Me
University of Texas Southwestern

Heath Rutledge-Jukes    -  Contact Me
Washington University in St. Louis School of Medicine; Centaur Labs Inc; King of the Curve LLC

Chuong Pham    -  Contact Me
Department of Adult Cardiovascular Surgery, University Medical Center Ho Chi Minh City

Thuan Phan Quang    -  Contact Me
Department of Adult Cardiovascular Surgery, University Medical Center Ho Chi Minh City

Nam Nguyen    -  Contact Me
University of Medicine and Pharmacy at Ho Chi Minh City

Dominique Vervoort    -  Contact Me
Institute of Health Policy, Management and Evaluation, University of Toronto

Phu Bui    -  Contact Me
College of Health Sciences, VinUniversity

Dinh Hoang Nguyen    -  Contact Me
University Medical Center Ho Chi Minh City

MINIMALLY INVASIVE MITRAL VALVE REPAIR USING ARTIFICIAL CHORDAE VIA RIGHT MINI‐THORACOTOMY: A SINGLE-CENTER EXPERIENCE

Objective: Minimally invasive mitral valve repair is known for its safety and efficacy, but the use of artificial chordae presents its own challenges, including technical difficulty, outcome variation, and the absence of standardized protocols. This study aims to analyze the mid-term outcomes of mitral valve repair using artificial chordae via right mini-thoracotomy.
Methods: The study analyzed all consecutive patients who underwent minimally invasive mitral valve repair using artificial chordae via right mini-thoracotomy at a single center in Vietnam between April 2016 and April 2022. The mitral valve repairs were divided into two groups based on a previously validated complexity score: simple repair (Group 1) and intermediate and complex repair (Group 2). Demographic information, comorbidities, surgical characteristics, surgical outcomes, and mid-term survival were analyzed. The primary endpoints were survival, freedom from reoperation, and recurrent mitral regurgitation.
Results: A total of 90 patients were analyzed, including 41 simple repairs and 49 intermediate-to-complex repairs. The mean patient age was 50.5 ± 12.9 years, with 77 (77.7%) being male. The mean annular mitral diameter was 39.2 ± 4.4 mm, and the vena contracta was 8.0 ± 1.6 mm. Myxomatous Barlow disease was present in 16 (17.8%) valves. The left ventricular dimensions slightly decreased after the repair. The mean follow-up time was 26.2 ± 16.1 months, with two (2.2%) deaths. All patients underwent ring annuloplasty, and the additional Alfieri edge-to-edge technique was applied in 6 (6.7%) cases, mostly in Group 2. Kaplan-Meier survival estimates at 12 and 24 months for both groups were 97% (92-100%) and 100% (P=.85), respectively. The recurrent mitral regurgitation estimates were 97% (92-100%) and 92% (84-100%) (P=.279), and 97% (92-100%) and 88% (79-99%) (P=.279), respectively. No reoperations occurred during the follow-up period.
Conclusion: Minimally invasive mitral valve repair using artificial chordae via right mini-thoracotomy is feasible, safe, and effective in a resource-limited country for patients with mitral regurgitation, regardless of the complexity of the valve repair. Further studies are needed to determine the long-term outcomes.

Minimally Invasive & Robotic Mitral Valve Repair