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MP41. One-Year Result of a Modified Loop Technique (Loop-In-Loop Technique)

Kazuma Okamoto Poster Presenter
Kindai University Hospital
Kobe, Hyogo 
Japan  - Contact Me

Current position:             

Associate Professor in Cardiovascular Surgery, Kindai University, Osaka, Japan

 

Postdoctoral Training:

1999 – 2004     Resident in Surgery and Cardiac surgery, Keio University, School of Medicine, Tokyo, Japan 

2004 – 2006     Reserch Resident in Department of Reproductive Biology and Pathology, National Research Institute for Child Health and Development, Tokyo, Japan

2006 – 2007      Chief Resident in Cardiovascular Surgery,  Keio University School of Medicine, Tokyo, Japan

2007 – 2008      Clinical Fellow in Department of Thoracic and Cardiovascular Surgery,  OLV Clinic, Aalst, Belgium

2008 – 2009      Clinical Fellow in Department of Cardiac Surgery,  IRCCS Istituto Policlinico San Donato, San Donato Milanase, Italy

2010                 Clinical Fellow in Department of Cardiovascular Surgery,  Chiang Mai University, Thailand

2010 –               Assistant Professor in Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan

2012 – 2016      Associate Professor in Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan

2016 –               Chief of the Akashi Institute of Minimally Invasive Cardiovascular Intervention, Akashi Medical Center, Akashi, Japan

2021-                 Associate Professor in Cardiovascular Surgery, Kindai University, Osaka, Japan

Thursday, May 4, 2023: 6:30 PM - Saturday, May 6, 2023: 2:29 AM
New York Hilton Midtown 
Room: Grand Ballroom Foyer 

Description

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.

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