Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: A propensity-matched comparison

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

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An 86-Year-Old Female with Mitral Regurgitation and Significant Pectus Excavatum

The Thoracic and Cardiovascular Surgeon Reports ◽

10.1055/s-0039-1700881 ◽

2019 ◽

Vol 08 (01) ◽

pp. e37-e40

Author(s):

Raphael Tasar ◽

Sophie Tkebuchava ◽

Mahmoud Diab ◽

Torsten Doenst

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Pectus Excavatum ◽

Heart Team ◽

Case Description ◽

Valve Repair ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Surgical Access

Abstract Background We report the case of minimally invasive mitral valve repair in an 86-year-old female with symptomatic structural mitral regurgitation and severe pectus excavatum. Case Description The case summarizes four areas of repetitive heart team discussions. First, should an 86-year-old patient still be treated invasively? Second, if so, should treatment be interventional or surgical? Third, if surgical, should we replace or repair at that age and fourth which surgical access is best with respect to her chest deformation? Conclusion We chose to surgically repair the valve using a minimally invasive approach. The patient was extubated 3 hours after surgery and discharged after 7 days.

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A Simplified Technique for Correcting Mitral Valve Regurgitation via Minimally Invasive Approach

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000497 ◽

2018 ◽

Vol 13 (3) ◽

pp. 236-238

Author(s):

Giuseppe Speziale ◽

Marco Moscarelli

Keyword(s):

Cardiopulmonary Bypass ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Mitral Valve Regurgitation ◽

Valve Regurgitation ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Repair Techniques

Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months, freedom from recurrent of mitral regurgitation 2+ or greater and reoperation was 95.2%.

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Chordal Tethering: A Unique Cause of Structural Mitral Regurgitation in Dilated Cardiomyopathy

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31806165f5 ◽

2007 ◽

Vol 2 (3) ◽

pp. 122-123

Author(s):

Saqib Masroor ◽

Robert Berkowitz ◽

John C. Alexander

Keyword(s):

Ventricular Tachycardia ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Dilated Cardiomyopathy ◽

Medical Therapy ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Ventricular Dyssynchrony

Mitral regurgitation in dilated cardiomyopathy is usually considered “functional,” and many such patients are treated medically. Surgery is often offered as a last resort in select patients who have failed medical therapy. We report a patient with dilated cardiomyopathy with ventricular tachycardia and ventricular dyssynchrony and “structural mitral regurgitation” due to chordal tethering, which was managed surgically using a minimally invasive approach.

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Minimally Invasive Mitral Valve Replacement Using the Valve-in-valve Technique

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3181b02871 ◽

2009 ◽

Vol 4 (4) ◽

pp. 221-224 ◽

Cited By ~ 1

Author(s):

Orlando Santana ◽

Francisco A. Tarrazzi ◽

Joseph Lamelas

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Pulmonary Edema ◽

Left Atrium ◽

Bioprosthetic Valve ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Valve In Valve ◽

Bioprosthetic Mitral Valve

A 90-year-old woman with two previous mitral valve replacements, presented with pulmonary edema due to mitral regurgitation from degeneration of her bioprosthetic mitral valve. A minimally invasive approach was used to replace the bioprosthetic mitral valve. During surgery, the bioprosthetic valve was noted to be too adherent to the endocardium of the left atrium, making removal of the prosthesis not only difficult, but also potentially harmful. The new bioprosthetic valve was instead placed using a valve-in-valve approach.

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Transapical Off-Pump Neochord Implantation in Case of Severe Mitral Regurgitation

Acta Chirurgica Latviensis ◽

10.1515/chilat-2017-0007 ◽

2016 ◽

Vol 16 (2) ◽

pp. 28-30

Author(s):

Uldis Strazdins ◽

Gvido Janis Bergs ◽

Martins Kalejs ◽

Indra Vilumsone

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Invasive Procedure ◽

Valve Repair ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Off Pump ◽

Significant Clinical Improvement ◽

Artificial Chordae

SummaryMitral regurgitation is common valvular heart disease and a major cause of congestive heart failure and death. It is most often associated with degenerative changes in mitral valve which leads to valve prolapse. Transapical off-pump mitral valve repair is a new minimally invasive procedure to treat mitral regurgitation. Here we report 64-year old female who suffered from grade III mitral regurgitation due to ruptured chorda and posterior leaflet P2/P3 segment prolapse. During surgery 4 artificial chordae were implanted and postoperative echocardiography results showed minimal residual grade I mitral regurgitation, therefore significant clinical improvement can be achieved with minimally invasive approach.

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