Key result
Thoracoscopic mitral valvuloplasty was technically feasible and safe in 100 consecutive cases, with 95% of patients having no mitral regurgitation intraoperatively and 1 operative death.
Why the study?
The study evaluated the safety and feasibility of thoracoscopic mitral valvuloplasty through early clinical outcomes in an institutional series.
Is thoracoscopic mitral valvuloplasty safe and feasible for mitral valve repair?
Observational (n=100)
No
Is thoracoscopic mitral valvuloplasty safe and feasible for mitral valve repair?
Totally thoracoscopic mitral valvuloplasty appears technically feasible and safe with acceptable early clinical outcomes after crossing the learning curve.
BACKGROUND: We reported our experience of 100 consecutive cases of thoracoscopic mitral valvuloplasty in the early period. METHODS: Between September 2017 and December 2019, 100 consecutive cases (aged 49.2±14.7 years; 56% male) of thoracoscopic mitral valvuloplasty had been completed in our institution. The safety and feasibility of this technique was evaluated by its early clinical outcomes. RESULTS: Mitral valve (MV) repair was performed by means of Carpentier techniques, including leaflet folding in 5 cases, cleft suture in 10, commissuroplasty in 15 including 2 commissurotomy, edge to edge in 1, artificial chordae implantation in 76 cases with an average of 2.5±1.6 (1 to 4) pairs, and prosthetic annuloplasty in all cases. Intraoperative transoesophageal echocardiography (TEE) revealed no mitral regurgitation (MR) in 95 cases and a mild in 2 cases with all coaptation length more than 5 mm. The rest 3 cases with moderate or more MR were successfully reconstructed during a second pump-run. The average cardiopulmonary bypass (CPB) time was 164.4±51.0 min and aortic clamping time was 119.7±39.1 min, and the latest 10 cases were 140.2±45.3 and 96.3±25.4 min, respectively (P<0.05). There was only one operative death from avulsion of left atrial suture after operation and 2 intraoperative re-exploration through a conversion to sternotomy for bleeding. Severe MR was observed in 2 patients 3 months after operation, and MV replacement (MVR) was performed through median sternotomy. CONCLUSIONS: Totally thoracoscopic mitral valvuloplasty was technically feasible, safe, effective, and reproducible in clinical practice after crossing the learning curve.
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Cui et al. (2020) conducted an observational in Mitral valve disease (n=100). Thoracoscopic mitral valvuloplasty was evaluated on Early clinical outcomes (safety and feasibility). Thoracoscopic mitral valvuloplasty was technically feasible and safe in 100 consecutive cases, with 95% of patients having no mitral regurgitation intraoperatively and 1 operative death.
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