scholarly journals Ring-first Mitral Valve Repair

2020 ◽  
Vol 6 ◽  
Author(s):  
Marco Cirillo
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Surgical Reconstruction ◽  
Valve Repair ◽  
Residual Stenosis ◽  
Geometrical Arrangement ◽  
Mitral Repair ◽  
Ring Annuloplasty ◽  
Residual Tissue ◽  
Repair Techniques

Mitral valve repair is one of the most frequent interventions in cardiac surgery. It involves eliminating the dysfunctional part(s) of the mitral valve and reconstructing, using the residual tissue or with the addition of prosthetic components, a properly functioning valve, without residual stenosis or regurgitation. A fundamental component of mitral repair is the implantation of a ring (annuloplasty) which reconstitutes the normal, saddle-shaped geometry of the valve. Such ring is usually implanted at the end of the surgical reconstruction regardless of the repair techniques. The implantation of the ring can however change the final anatomy of the valve in an unexpected way and therefore force new corrective surgical actions. We therefore propose a research project that plans the execution of annuloplasty as the first surgical step and then the correction of the valvular disease affecting the leaflets and chordae. The sizing of the ring is always performed on parts of the valve that are usually not changed during the reconstructive surgery, therefore it is possible to decide its size before surgically correcting the valve. In this way we could act on the leaflets and chordae in the definitive geometrical arrangement of the mitral valve.

ECHOCARDIOGRAPHY PREDICTORS OF SUCCESSFUL MITRAL VALVE REPAIR IN DEGENERATIVE MITRAL VALVE REGURGITATION

2015 ◽  
pp. 77-82
Author(s):  
Ba Minh Du Le ◽  
Anh Vu Nguyen ◽  
Duc Phu Bui
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Success Rate ◽  
Mitral Valve Repair ◽  
Transthoracic Echocardiography ◽  
Mitral Valve Prolapse ◽  
Posterior Leaflet ◽  
Valve Repair ◽  
Mitral Repair ◽  
Fibroelastic Deficiency

Background and aim of the study: Mitral repair is now as the treatement of choice in patients suffering mitral regurgitation due to mitral valve prolapse or flail. However, mitral valve repair demands the mitral valve morphology being feasible for repair. The study aims at evaluating transthoracic and transesophageal echocardiographic features in consecutive patients with mitral valve prolapse or flail undergoing surgical repair at Hue Central Hospital. The correlation between preoperative and intraoperative echocardiographic features and surgical findings in these patients. These echocardiographic data may predict the surgical outcome. Methods: From December 2010 to January 2013, 73 patients (37 men, 36 women; average age 37.5) were recruited into the study. All patients had degenerative mitral valve disease causing important regurgitation and underwent systematic preoperative transthoracic echocardiography, preoperative and intraoperative transesophageal echocardiography for delineation of six segments (scallops) of anterior and posterior leaflets. Results: Among 73 patients, 64 patients were in fibroelastic deficiency (87.7%) and 9 patients suffered Barlow disease (12.3%). Mitral valve repair was performed in 52 patients (71.2%) and mitral replacement was performed in 21 patients (28.8%). All 52 mitral valve repair (81.3%) and 12 mitral valve replacement (18.7%) was performed in fibroelastic deficiency patients. All 9 Barlow patients must undergo mitral valve replacement (100%). A prolapse or flail of mitral valve in 73 patients was documented by transthoracic and transesophageal echocardiography and confirmed on surgical inspection. Accuracy of transthoracic echocardiography was (89.0%) and accuracy of transesophageal echocardiography was (91.8%) in identifying mitral valve segments prolapse or flail. Success rate of mitral valve repair was (98.0%) in prolapse of 1 or 2 segments, but was low (36.0%) in prolapse > 3 segments. Success rate of mitral valve repair was (96.6%) in prolapse of posterior leaflet, but was (63.6%) in prolapse anterior leaflet or bileaflet. Conclusion: - Mitral valve repair was favorable in fibroelastic deficiency patients, but difficult in Barlow patients. - Accuracy of transthoracic and transesophageal echocardiography was high in identifying mitral valve segments prolapse or flail. - Success rate of mitral valve repair was high in prolapse of 1 or 2 segments. - Success rate of mitral valve repair was high in in prolapse of posterior leaflet. Key words: Mitral repair, echocardiography, degenerative, Barlow, fibroelastic deficiency, prolapse, flail

Robotic Septal Myectomy Without Anterior Leaflet Incision during Mitral Valve Repair

2019 ◽  
Vol 14 (3) ◽  
pp. 281-285 ◽  
Author(s):  
Burak Onan ◽  
Ersin Kadirogullari ◽  
Zeynep Kahraman ◽  
Onur Sen
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Da Vinci Surgical System ◽  
Systolic Anterior Motion ◽  
Anterior Leaflet ◽  
Valve Repair ◽  
Septal Myectomy ◽  
Mitral Repair

Bulging subaortic septum in hypertrophic cardiomyopathy is a potential risk factor for systolic anterior motion after mitral valve repair. Systolic anterior motion may cause postoperative mitral regurgitation and left ventricular outflow tract obstruction despite conservative management. During “minimally invasive endoscopic” and “robotic” mitral repair procedures, systolic anterior motion is prevented with concomitant septal myectomy through the mitral valve orifice. Technically, the exposure of the bulging subaortic septum is traditionally done with detachment of the anterior mitral leaflet from its annulus, leaving a 2-mm rim of leaflet attached to the annulus. The leaflet is then sutured after myectomy. As an alternative technique in robotic surgery, the exposure of the subaortic septum is feasible without anterior leaflet incision with the use of dynamic atrial retractor in mitral repair procedures. Here, we present a patient who underwent concomitant robotic mitral valve repair with posterior chordal implantation, ring annuloplasty, and septal myectomy without anterior leaflet incision using the da Vinci surgical system.

Early and Mid-term Results of Mitral Valve Repair in Patients with Degenerative Mitral Regurgitation

2021 ◽  
Author(s):  
Hasan Erdem ◽  
Emre Selçuk
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Survival Rates ◽  
Mitral Valve Regurgitation ◽  
Valve Repair ◽  
Repair Rate ◽  
Mitral Repair ◽  
Mid Term Results

Objectives: In this study, we present the mid-term results of patients who underwent valve repair due to degenerative mitral valve regurgitation in the first five years of our mitral valve repair program. Patients and Methods: In this retrospective study, all patients who were operated for degenerative mitral regurgitation by a single surgical team between 2013 and 2017 were investigated. We determined early and mid-term cumulative survival rates, repair failure and freedom from reoperation. In addition, as a specific subgroup, the results of patients under 18 years of age after mitral valve repair were investigated Results: Mitral repair was performed in 121 of 153 degenerative mitral regurgitation patients during the study period. The overall repair rate was 79%. Mitral valve repair rate increased significantly over years. The Median follow-up time was 63 (range 10-92) months. Early mortality was 2.5% (n=3 patients). During the follow-up period, moderate-to-severe mitral regurgitation was observed in 14 (11.8%) patients, mitral valve reoperation was required in 7 (5.9%) patients. Valve repair was performed in 4 of 7 patients under the age of 18. There was no pediatric case requiring reoperation during the follow-up period (median 46 months). Conclusion: Mid-term results of mitral valve repair in degenerative mitral valve patients are satisfactory. The success rate of repair increases in line with surgical experience.

scholarly journals Microinvasive Mitral Valve Surgery: A New Frontier to Tackle Mitral Regurgitation

2021 ◽  
Author(s):  
Solomon Seifu ◽  
Eduardo de Marchena
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Repair System ◽  
Valve Repair ◽  
Mitral Repair ◽  
New Frontier ◽  
Clinical Benefits

Microinvasive, catheter-based mitral valve repair of severe mitral regurgitation utilizes less invasive approaches with less procedural morbidity and mortality. The procedural steps and clinical benefits of the transcatheter transapical mitral valve annuloplasty (AMEND mitral repair implant) and transcatheter transapical chordal repair systems (Neochord DS 1000 device and Harpoon Mitral Valve Repair System) are reviewed in this manuscript.

scholarly journals Feasibility of novel transapical off pump beating heart mitral valve repair in a patient with dextrocardia and situs inversus

2020 ◽  
Vol 58 (2) ◽  
pp. 392-394
Author(s):  
Inderjeet Bhatia ◽  
Daniel Tai-Leung Chan ◽  
Simon Chi-Cheung Lam ◽  
Timmy Wing-Kuk Au
Keyword(s):  
Mitral Valve ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Situs Inversus ◽  
Beating Heart ◽  
Invasive Technique ◽  
Valve Repair ◽  
Off Pump ◽  
Mitral Repair

Abstract We present a case to demonstrate the feasibility of transapical beating heart mitral valve repair in a patient with dextrocardia. This minimally invasive technique provides simple, safe and satisfactory mitral repair. The surgical technique, outcome and prognosis are not affected by the condition.

scholarly journals Mitral valve repair for infective endocarditis: Kobe experience

2020 ◽  
Vol 28 (7) ◽  
pp. 384-389
Author(s):  
Yukikatsu Okada ◽  
Takeo Nakai ◽  
Takashi Muro ◽  
Hisato Ito ◽  
Yu Shomura
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Event Free Survival ◽  
Valve Repair ◽  
Free Survival ◽  
Autologous Pericardium ◽  
Ring Annuloplasty ◽  
Group A ◽  
Group B

Objectives We retrospectively analyzed our experience of mitral valve repair for native mitral valve endocarditis in a single institution. Methods From January 1991 to October 2011, 171 consecutive patients underwent surgery for infective endocarditis. Of these, 147 (86%) had mitral valve repair. At the time of surgery, 98 patients had healed (group A) and 49 had active infective endocarditis (group B). Repair procedures included resection of all infected tissue and thick restricted post-infection tissue, leaflet and annulus reconstruction with treated autologous pericardium, chordal reconstruction with polytetrafluoroethylene sutures, and ring annuloplasty if necessary. Fifty-two (35%) patients required concomitant procedures. The study endpoints were overall survival, freedom from reoperation, and freedom from valve-related events. The median follow-up was 78 months. Results There was one hospital death (hospital mortality 0.7%). Survival at 10 years was 88.5% ± 3.5% with no significant difference between the two groups ( p = 0.052). Early reoperation was required in 4 patients in group B due to persistent infection or procedure failure. Freedom from reoperation at 5 years was 99% ± 1.0% in group A and 89.6 ± 4.0% in group B ( p = 0.024). Event-free survival at 10 years was 79.3% ± 4.8% (group A: 83.4% ± 5.9%, group B: 72.6% ± 6.9%, p = 0.010). Conclusions Mitral valve repair was highly successful using autologous pericardium, chordal reconstruction, and ring annuloplasty if required. Long-term results were acceptable in terms survival, freedom from reoperation, and event-free survival. Mitral valve repair is recommended for mitral infective endocarditis in most patients.

Unusual interatrial membrane in the left atrium: A newer obstacle for transseptal-based percutaneous mitral valve repair techniques?

2017 ◽  
Vol 34 (9) ◽  
pp. 1379-1381
Author(s):  
Antonio Popolo Rubbio ◽  
Sarah Mangiafico ◽  
Salvatore Scandura ◽  
Sergio Buccheri ◽  
Marco Barbanti ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Percutaneous Mitral Valve Repair ◽  
Repair Techniques

scholarly journals A Dynamic Heart System to Facilitate the Development of Mitral Valve Repair Techniques

2009 ◽  
Vol 37 (4) ◽  
pp. 651-660 ◽  
Author(s):  
Andrew L. Richards ◽  
Richard C. Cook ◽  
Gil Bolotin ◽  
Gregory D. Buckner
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Repair Techniques

scholarly journals Mitral Valve Replacement—Current and Future Perspectives

2017 ◽  
Vol 9 ◽  
pp. 117906521771902 ◽  
Author(s):  
Johan van der Merwe ◽  
Filip Casselman
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Future Perspectives ◽  
Valve Repair ◽  
Experimental Approaches ◽  
Repair Techniques

The favorable outcomes achieved with modern mitral valve repair techniques redefined the role of mitral valve replacement. Various international databases report a significant decrease in replacement procedures performed compared with repairs, and contemporary guidelines limit the application of surgical mitral valve replacement to pathology in which durable repair is unlikely to be achieved. The progressive paradigm shift toward endoscopic and robotic mitral valve surgery is also paralleled by rapid developments in transcatheter devices, which is progressively expanding from experimental approaches to becoming clinical reality. This article outlines the current role and future perspectives of contemporary surgical mitral valve replacement within the context of mitral valve repair and the dynamic evolution of exciting transcatheter alternatives.

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