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Minimally invasive edge-to-edge mitral repair with or without artificial chordae.

Publication ,  Journal Article
Chen, X; Turley, RS; Andersen, ND; Desai, BS; Glower, DD
Published in: Ann Thorac Surg
April 2013

BACKGROUND: This study aims to analyze the midterm outcomes of minimally invasive edge-to-edge mitral valve repair (MVR) with artificial chords (CHORD) or without artificial chords (noCHORD) in patients with mitral regurgitation (MR). METHODS: Records of all patients undergoing edge-to-edge MVR through minithoracotomy at a single institution over a 7-year period were retrospectively reviewed. RESULTS: A total of 186 patients underwent edge-to-edge MVR through minithoracotomy. Disease etiology was posterior prolapse in 73 (39%) and bileaflet prolapse in 77 (41%). Edge-to-edge sutures were used at A1-P1 in 20 patients (11%), A2-P2 in 136 (73%), and A3-P3 in 30 (16%). Annuloplasty rings were placed in 184 patients (99%), with a mean size of 36±5 mm. Mean follow-up was 2 years (range, 0 to 6), with mean mitral gradient 4±2 mm Hg, MR mild or less in 179 of 186 (96%), 4 (2%) late reoperations, and 1 (0.5%) late death. The CHORD patients (n=71) were more likely than the noCHORD patients (n=115) to have extensive posterior leaflet pathology (p<0.01), had longer clamp and pump times (p<0.01) and were less likely to need leaflet resection (p=0.002), but had similar postoperative courses. At 3 years, freedom from moderate MR was less in CHORD versus noCHORD patients (88±6 versus 100%, p=0.001), but freedom from reoperation was similar (96%±3% versus 99%±1%, p=not significant). CONCLUSIONS: Early results suggest that edge-to-edge MVR can be safe and effective in patients with mitral regurgitation. Edge-to-edge MVR combined with artificial chordae may be useful in selected patients, but with some risk of recurrent moderate MR.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

April 2013

Volume

95

Issue

4

Start / End Page

1347 / 1353

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Thoracotomy
  • Suture Techniques
  • Retrospective Studies
  • Respiratory System
  • Mitral Valve Prolapse
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Minimally Invasive Surgical Procedures
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chen, X., Turley, R. S., Andersen, N. D., Desai, B. S., & Glower, D. D. (2013). Minimally invasive edge-to-edge mitral repair with or without artificial chordae. Ann Thorac Surg, 95(4), 1347–1353. https://doi.org/10.1016/j.athoracsur.2012.12.026
Chen, Xujun, Ryan S. Turley, Nicholas D. Andersen, Bhargavi S. Desai, and Donald D. Glower. “Minimally invasive edge-to-edge mitral repair with or without artificial chordae.Ann Thorac Surg 95, no. 4 (April 2013): 1347–53. https://doi.org/10.1016/j.athoracsur.2012.12.026.
Chen X, Turley RS, Andersen ND, Desai BS, Glower DD. Minimally invasive edge-to-edge mitral repair with or without artificial chordae. Ann Thorac Surg. 2013 Apr;95(4):1347–53.
Chen, Xujun, et al. “Minimally invasive edge-to-edge mitral repair with or without artificial chordae.Ann Thorac Surg, vol. 95, no. 4, Apr. 2013, pp. 1347–53. Pubmed, doi:10.1016/j.athoracsur.2012.12.026.
Chen X, Turley RS, Andersen ND, Desai BS, Glower DD. Minimally invasive edge-to-edge mitral repair with or without artificial chordae. Ann Thorac Surg. 2013 Apr;95(4):1347–1353.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

April 2013

Volume

95

Issue

4

Start / End Page

1347 / 1353

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Thoracotomy
  • Suture Techniques
  • Retrospective Studies
  • Respiratory System
  • Mitral Valve Prolapse
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Minimally Invasive Surgical Procedures