A new simplified technique for artificial chordae implantation in mitral valve repair with its early results

Abstract

Background: Many techniques in mitral valve repair (MVR) have been reported with successful longterm results. The aim of this study is to present our simplified technique in artificial chordae replacement for MVR, and reporting its short-term outcomes. Methods: We present a prospective single-surgeon experience. A new simplified artificial chordae implantation technique has been used to repair mitral valves. Postoperative echocardiography at 0, 6, then every 12 months is used to control the results. Endpoints involved freedom from mitral regurgitation (MR), reoperation and major adverse cardiac and cerebrovascular events (MACCE).Results: Between 01/2016 and 01/2018, 57 consecutive patients undergo MVR using this technique are evaluated. Mean age was 63.6±10.1 years and 68.4% were male. Mitral valve pathology was mainly degenerative (52, 91.2%) or healed endocarditis (5, 8.8%). Besides chordae replacement (3.6±1.1 per patient), annuloplasty was used in all patients to correct annulus dilation and stabilize the repair. Mean cross-clamping time was 53±13.4 minutes in isolated MVR and 69.4±31.1 minutes in concomitant procedures. Postoperative outcomes reported two mortalities. Discharge echocardiography reported mild MR in 4 patients and the rest of patients had non-to trace regurgitation. Follow-up results within a mean of 19.3±8.5 months reported no significant MR or need for reoperation and three more (non-valve related) mortalities.Conclusions: Our simplified technique allows to reduce the number of used chordae and re-correction if needed, which consequently reduces cross-clamping and bypass time especially in endoscopic MVR. Good intraoperative and short-term results are reported. These results are still under investigation to prove longterm stability of the repair.

Echocardiographic right ventricular evaluation in cardiac surgery patients undergoing mitral valve reconstruction: a single center prospective observational study

“…Postoperative RV-dysfunction is common after MV repair and could be accompanied by a LV dysfunction, which may persist for years, which in turn may influence patients’ long-term outcome. In this prospective analysis, all patients received MV repair via different surgical strategies even those presenting with MV endocarditis ( 24 , 25 ). Data reporting RV functions after MV surgery are controversial.…”

Conventional Biological versus Sutureless Aortic Valve Prostheses in Combined Aortic and Mitral Valve Replacement

“…Considering that rheumatic heart disease is rather uncommon in the Western world, we are looking at a cohort of elderly patients with at least an intermediate surgical risk undergoing a combined valve procedure. Moreover, our relatively high mortality and complications rates could be explained by the fact that in our center the rate of successful mitral valve repair is exceptionally high, therefore those patients undergoing a mitral valve replacement represent a group where the mitral valve is destructed beyond repair, thus carrying the highest operative risk [ 14 , 15 ].…”

Correlation between Doppler Echocardiography and Right Heart Catheterization Assessment of Systolic Pulmonary Artery Pressure in Patients with Mitral Regurgitation: A Prospective Observational Study

“…In the current prospective observational study, we evaluated the difference between both measurement of pulmonary artery pressure in 146 patients presented with MR. PH is known to be a common pathology in patients with left-side valvular diseases [ 2 ]. The majority of patients (n = 120; 82.2%) underwent mitral valve repair with different repair techniques [ 24 ]. Valve repair was also possible even in patients presented with valve endocarditis, repair techniques in cases of endocarditis was earlier reported [ 25 ].…”