MP32. Minimally Invasive Mitral Valve Repair Using Artificial Chordae via Right Mini‐Thoracotomy: A Single-Center Experience
Presented During: Moderated E-Posters
University Medical Center Ho Chi Minh City
Ho Chi Minh, NA
Viet Nam - Contact Me
Head of Cardiovascular Surgery Dept, UMC, Ho Chi Minh City
A/Prof. Cardiothoracic and Vascular Dept, University of Medicine and Pharmacy at HCMC, Viet Nam
Vice-President, Assocoation of Thoracic and Cardiovascular Surgeons of Viet Nam
Thursday, May 4, 2023: 6:30 PM - Saturday, May 6, 2023: 2:29 AM
New York Hilton Midtown
Room: Grand Ballroom Foyer
Description
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.
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.