scholarly journals Actual perspective on off-pump transapical artificial chord implantation

2021 ◽  
Author(s):  
Andrea Colli
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
High Volume ◽  
Mitral Valve Surgery ◽  
Valve Repair ◽  
Transfemoral Approach ◽  
Off Pump ◽  
Artificial Chordae ◽  
Small Cohort

Mitral valve repair (MVR) is undisputedly associated with better clinical and functional outcomes than any other type of valve substitute. Conventional mitral valve surgery in dedicated high-volume centers can assure excellent results in terms of mortality and freedom from mitral regurgitation (MR) recurrence but requires cardiopulmonary bypass (CPB) and cardioplegic heart arrest. Trying to replicate the percentage of success of surgical MVR is the aim of all new transcatheter mitral dedicated devices. In particular transapical beating-heart mitral valve repair by artificial chordae implantation with transesophageal echocardiography (TEE) guidance is an expanding field. The safety and feasibility of the procedure have already been largely demonstrated with Neochord and more recently with Harpoon systems. Wang et al. present the outcomes of the first-in-human experience using a novel artificial chordae implantation device, the Mitralstitch system. Despite a quite small cohort of only 10 patients treated, 1-year results are satisfying and comparable to the early experience with former devices (4 patients with moderate or more MR recurrence). The comparison with surgical MVR is still unfavorable and requires further studies and significant procedure improvement. However, the device permits the treatment of anterior and posterior leaflets prolapse and performs quite easily edge-to-edge reparation. It will be interesting to evaluate longer follow-up in larger cohorts of patients as well as the possibility to shift to the transfemoral approach.

Off-pump Transapical Mitral Valve Repair with Implantation of Neo-chordae

2011 ◽  
Vol 7 (3) ◽  
pp. 181
Author(s):  
Michael Hoebartner ◽  
Philipp Kiefer ◽  
Michael Andrew Borger ◽  
Friedrich Wilhelm Mohr ◽  
Joerg Seeburger ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Beating Heart ◽  
Severe Mitral Regurgitation ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Off Pump ◽  
Repair Procedure ◽  
Artificial Chordae

The authors present a case report of a mitral valve repair procedure featuring beating-heart, sternal-sparing implantation of neo-chordae. The 73-year-old female patient had severe mitral regurgitation (MR) pre-operatively, but no MR post-operatively and at 30-day follow-up. The patient was enrolled in the Transapical artificial chordae tendineae (TACT) trial sponsored by NeoChord Inc.

Idiopathic Acute Mitral Regurgitation Due to Chordal Rupture in Infants: Surgical Management and Results

2019 ◽  
Vol 10 (1) ◽  
pp. 37-41
Author(s):  
Kosuke Yoshizawa ◽  
Keiichi Fujiwara ◽  
Nobuhisa Ohno ◽  
Kentaro Watanabe ◽  
Hisanori Sakazaki
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Surgical Intervention ◽  
Valve Repair ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Acute Mitral Regurgitation ◽  
Artificial Chordae

Objective: Emergency surgical treatment is required for idiopathic acute mitral regurgitation due to chordae rupture in infants. Nevertheless, mitral valve repair for such a patient population still remains challenging. We report our experience with mitral valve repair for idiopathic acute mitral regurgitation due to chordae rupture in infants. Methods: From 2005 to 2017, six infants (four boys) were diagnosed with acute mitral regurgitation due to chordae rupture and underwent mitral valve repair. The median age, mean body weight, and median follow-up period were 5.5 months (range: 4-9 months), 6.8 kg (range: 5.5-8.0 kg), and 6.4 years (range: 6 months to 10 years), respectively. Results: In all cases, surgical intervention was performed within 24 hours of admission. Artificial chordae reconstruction and paracommissural edge-to-edge repair were utilized in three and four cases, respectively, while Kay’s annuloplasty was performed in all cases. Mean cardiopulmonary bypass time and aortic cross-clamp time were 117 minutes (range: 70-143 minutes) and 73 minutes (range: 35-108 minutes), respectively. No early or late deaths and reoperations had occurred during the follow-up period. Moreover, postoperative mitral regurgitation was significantly reduced, while no chronologic progression of mitral regurgitation was observed. Conclusions: The combination of various techniques, such as artificial chordae reconstruction, paracomissural edge-to-edge repair, and Kay’s annuloplasty, can be a promising surgical option for idiopathic acute mitral regurgitation due to chordae rupture in infants.

scholarly journals Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study

2009 ◽  
Vol 137 (1) ◽  
pp. 188-193 ◽  
Author(s):  
Pietro Bajona ◽  
William E. Katz ◽  
Richard C. Daly ◽  
Kenton J. Zehr ◽  
Giovanni Speziali
Keyword(s):  
Mitral Valve ◽  
Animal Study ◽  
Mitral Valve Repair ◽  
Beating Heart ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Off Pump ◽  
Artificial Chordae

scholarly journals Minimally invasive mitral valve repair for degenerative etiology: a comparative study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Mohamed Abdel Hafez Fouly ◽  
Tarek K. Mousa
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Median Sternotomy ◽  
Mitral Valve Surgery ◽  
Valve Repair ◽  
Significant Difference ◽  
The Mean ◽  
Group 2

Abstract Background There is a paucity of data comparing the minimally invasive mitral valve repair (MiMVr) to the conventional approach in patients with degenerative disease. Our objective was to compare the outcomes of MiMVr to the traditional mitral valve repair through median sternotomy in patients with degenerative mitral valve disease. We conducted a retrospective study on 215 patients classified into two groups. Group 1 (n = 80) included those who had mitral valve repair through a right anterolateral video-assisted mini-thoracotomy, and group 2 (n = 135) was approached through a conventional median sternotomy. We compared the preoperative, operative, and postoperative data between groups. Both groups had echocardiographic follow-ups after 6 and 12 months. Results There was no difference in gender distribution between both groups, and patients who had median sternotomy were significantly older (median 37 (Q1-Q3, 29-44) vs. 54 (48-60) years; P < 0.001). Cardiopulmonary bypass (134.5 (130-138.5) vs. 99 (97-104) min; P < 0.001) and ischemic times (99 (95-105.5) vs. 78 (75-81) min; P < 0.001) were significantly shorter in patients who had median sternotomy. Patients with MiMVr had significantly lower blood loss (370 (315-390) vs. 550 (490-600) ml; P < 0.001) and ICU stay (5 (4.5-6) vs. 7 (7-8) days; P < 0.001). There was no difference between both groups regarding re-exploration for bleeding, postoperative stroke, wound infection, renal failure, and mortality. As regards postoperative echocardiography follow-up at 6 and 12 months after the operation, there were no significant changes in the mean mitral valve gradient within each group; however, the mean gradient was lower in the MiMVr group (3 (3-3.5) vs. 4 (3-5) mmHg; P < 0.001). There was no significant difference between both groups regarding mitral regurgitation severity during 6 and 12 months follow-up. Conclusion Minimally invasive mitral valve repair in patients with degenerative pathology could be an alternative to conventional mitral valve surgery with comparable short-term and long-term outcomes.

scholarly journals Transapical off-pump mitral valve repair following prior mitral valve surgery

Medicine ◽  
2021 ◽  
Vol 100 (21) ◽  
pp. e26148
Author(s):  
Hermann Blessberger ◽  
Joerg Kellermair ◽  
Juergen Kammler ◽  
Clemens Steinwender ◽  
Andreas F. Zierer
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Repair ◽  
Off Pump

RF87 TRANSAPICAL OFF-PUMP MITRAL VALVE REPAIR WITH PTFE CHORD IMPLANTATION

2018 ◽  
Vol 19 ◽  
pp. e55
Author(s):  
L. Bardaro ◽  
A. Carrozzo ◽  
A. Albertini ◽  
K. Fattouch ◽  
L. Martinelli
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Off Pump

scholarly journals Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Benito Gonzalez ◽  
X Freixa ◽  
C Godino ◽  
M Taramasso ◽  
R Estevez-Loureiro ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
One Year ◽  
The Impact

Abstract Background Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction, functional mitral regurgitation grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results 93 patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-months follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0–17.8 vs 2.7–13.5, p=0.002), sustained VT or ventricular fibrillation (0.9–2.5 vs 0.5–2.9, p=0.012) and ICD antitachycardia therapies (2.5–12.0 vs 0.9–5.0, p=0.033) were observed. Conclusion PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort. Proportion of patients who presented ven Funding Acknowledgement Type of funding source: None

scholarly journals Minimally-invasive mitral valve repair of symmetric and asymmetric Barlow´s disease

2021 ◽  
Author(s):  
Gloria Faerber ◽  
Sophie Tkebuchava ◽  
Mahmoud Diab ◽  
Christian Schulze ◽  
Michael Bauer ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Wide Spectrum ◽  
Mitral Valve Surgery ◽  
Valve Repair ◽  
Prolapse Repair ◽  
Repair Rate ◽  
Barlow’S Disease ◽  
Increased Risk

Abstract Objectives Barlow´s disease represents a wide spectrum of mitral valve pathologies associated with regurgitation (MR), excess leaflet tissue, and prolapse. Repair strategies range from complex repairs with annuloplasty plus neochords through resection to annuloplasty-only. The latter requires symmetric prolapse patterns and central regurgitant jets. We aimed to assess repair success and durability, survival, and intraoperative outcomes with symmetric and asymmetric Barlow’s disease. Methods Between 09/10 and 03/20, 103 patients (of 1939 with mitral valve surgery) presented with Barlow´s disease. All received surgery through mini-thoracotomy with annuloplasty plus neochords (n = 71) or annuloplasty-only (n = 31). One valve was replaced for endocarditis (repair rate: 99%). Results Annuloplasty-only patients were older (64 ± 16 vs. 55 ± 11 years, p = 0.008) and presented with higher risk (EuroSCORE II: 4.2 ± 4.9 vs. 1.6 ± 1.7, p = 0.007). Annuloplasty-only patients had shorter cross-clamp times (53 ± 18 min vs. 76 ± 23 min, p < 0.001) and received more tricuspid annuloplasty (15.5% vs. 48.4%, p < 0.001). Operating times were similar (170 ± 41 min vs. 164 ± 35, p = 0.455). In three patients, annuloplasty-only caused intraoperative systolic anterior motion (SAM), which was fully resolved by neochords to the posterior leaflet. There were no conversions to sternotomy or deaths at 30-days. Three patients required reoperation for recurrent MR (at 25 days, 2.8 and 7.8 years). At the latest follow-up, there was no MR in 81.4%, mild in 14.7%, and moderate in 2.9%. Three patients died due to non-cardiac reasons. Surviving patients report the absence of relevant symptoms. Conclusions Minimally-invasive Barlow’s repair is safe with good durability. Annuloplasty-only may be a simple solution for complex but symmetric pathologies. However, it may carry an increased risk of intraoperative SAM.

Sign in / Sign up

Export Citation Format

Share Document