One-year result of a modified loop technique (Loop-in-Loop technique)

MP041 

Abstract Submission 

Kazuma Okamoto (1), Yumeka Tamai (1), Yuuto Hori (2), Naoya Miyashita (3), Shintaro Yukami (3), Shinsuke Kotani (3), Satoshi Asada (4), Tatsuya Ogawa (3), Genichi Sakaguchi (5)

(1) Kindai University Hospital, Osaka, Japan, (2) Kindai university, Osaka, Japan, (3) Kindai University, Osaka, Japan, (4) N/A, Osaka, Japan, (5) Kinki University, Osaka, Japan

Kazuma Okamoto    -  Contact Me
Kindai University Hospital

Yumeka Tamai    -  Contact Me
Kindai University Hospital

Yuuto Hori    -  Contact Me
Kindai university

Naoya Miyashita    -  Contact Me
Kindai University

Shintaro Yukami    -  Contact Me
Kindai University

Shinsuke Kotani    -  Contact Me
Kindai University

Satoshi Asada    -  Contact Me
N/A

Tatsuya Ogawa    -  Contact Me
Kindai University

Genichi Sakaguchi    -  Contact Me
Kinki University

Kazuma Okamoto    -  Contact Me
Kindai University Hospital

Objective: For a reproducible mitral valve repair, multiple neo-chordal creations are accepted as a major repair technique even for posterior leaflet pathology. Although the loop technique has been a standard way for this purpose, the decision of the length of the loop set was difficult. To resolve drawbacks in the original loop technique, a modified loop technique called the Loop-in-Loop technique was applied. It uses a premade loop set (4 loops and 8mm in length) as an anchor on the papillary muscle and the efficient length of a neo-chord is adjusted by a second loop that connects the anchor to the mitral leaflet.
Methods: In the current study, one-year results of the consequent 34 cases (Age 60.6±13.2 (31-84), Female 13) from 2019 to 2022 using the modified loop technique were verified retrospectively. Follow up date was 182.6±179.1 (4-618).
Results: An endoscopic-assisted small right mini-thoracotomy was applied in 28 cases. A daVinci surgical assist robot was used in two cases. The full-sternotomy approach was used in the remaining four cases. Mitral valve repair was completed in all attempted instances during the study period. Neochords were created for the anterior leaflet (4), the posterior leaflet (22), and both leaflets (8). The average number of neo chords was 3.6±1.5. Although plication of commissure or indentation was added in 15 cases, any leaflet resection was not added in the whole series. Ring annuloplasty was added with Medtronic CG Future Band (11), Edwards Physio Flex Ring (5), and Medtronic SimuPlus Band (18). The average size was 31.4±2.5. Tricuspid annuloplasty with a Medtronic Tri-Ad ring was added in four cases. Although all cases were discharged with equal to or less than mild mitral regurgitation, a recurrence of regurgitation was detected in a case 482 days after the surgery. The mean mitral valve pressure gradient was 3.0±1.2.
Conclusions: The modified loop technique was a reliable repair way for all kinds of mitral valve leaflet prolapse. It was reproducible in complicated mitral valve repair and realized a stable one-year result.

Mitral Repair Techniques & Strategies