Minimally Invasive Mitral Valve Repair Through Right Minithoracotomy-11-Year Single Institute Experience -
- 31 May 2018
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 82 (6), 1705-1711
- https://doi.org/10.1253/circj.CJ-17-1319
Abstract
Background: Although minimally invasive mitral valve repair (MIMVR) is increasingly being performed, only a few clinical studies from Japanese institutions have been reported. Methods and Results: From 2006 to 2017, 387 consecutive patients (135 females, mean age 56 +/- 13 years) underwent an initial isolated MIMVR through a right minithoracotomy. The mitral etiology was degenerative in 348, functional in 22, and endocarditis in 13 cases. Repair techniques included leaflet resection/plication in 280, chordal reconstruction in 109, and annuloplasty alone in 24 patients, and concomitant procedures included tricuspid valve repair and atrial fibrillation ablation in 70 (18.1%) and 78 (20.2%), respectively. Hospital mortality rate was 0.26%; 2 patients (0.5%) required intraoperative conversion to a median sternotomy. Perioperative morbidity included stroke (1.3%), reoperation for bleeding (0.8%), prolonged ventilation (0.5%), and permanent pacemaker implantation (2.1%). The transfusion rate was 14.7% and median ventilation time was 4 hours. Overall 5-year survival was 96.9%. For patients with degenerative mitral regurgitation (MR), the 5-year freedom from reoperation or severe recurrent MR, and freedom from >= moderate MR were 94.7% and 82.2%, respectively. Repair for anterior mitral leaflet prolapse and the initial 30 cases were associated with higher occurrence of recurrent MR. Conclusions: MIMVR can be performed safely with low levels of mortality and morbidity, and provides sufficient repair durability. A learning curve exists in terms of repair durability, especially for anterior mitral leaflet repair.Keywords
This publication has 31 references indexed in Scilit:
- Initial large-dose administration of modified St. Thomas' solutionAsian Cardiovascular and Thoracic Annals, 2013
- Evolution of operative techniques and perfusion strategies for minimally invasive mitral valve repairThe Journal of Thoracic and Cardiovascular Surgery, 2012
- Minimally Invasive versus Open Mitral Valve Surgery a Consensus Statement of the International Society of Minimally Invasive Coronary Surgery (ISMICS) 2010Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2011
- Minimally Invasive versus Conventional Open Mitral Valve Surgery a Meta-Analysis and Systematic ReviewInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2011
- Retroperitoneal Hematoma With Abdominal Compartment Syndrome During Minimally Invasive Mitral Valve ReplacementThe Annals of Thoracic Surgery, 2010
- Unilateral Re‐Expansion Pulmonary Edema: A Rare Complication Following One‐Lung Ventilation for Minimal Invasive Mitral Valve ReconstructionJournal of Cardiac Surgery, 2009
- Minimally invasive mitral valve surgery: a systematic review and meta-analysisEuropean Journal of Cardio-Thoracic Surgery, 2008
- Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients☆European Journal of Cardio-Thoracic Surgery, 2008
- ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic SurgeonsJournal of the American College of Cardiology, 2006
- A comparison of outcomes of mitral valve repair for degenerative disease with posterior, anterior, and bileaflet prolapseThe Journal of Thoracic and Cardiovascular Surgery, 2005