Key result
Combined off-pump mitral repair and thoracoscopic maze surgery resulted in sinus rhythm with minimal residual mitral regurgitation at 6 months in a 67-year-old man.
Case Report (n=1)
No
Combined off-pump mitral repair and thoracoscopic maze surgery is a feasible, less invasive approach that can effectively treat severe mitral regurgitation and paroxysmal atrial fibrillation in selected patients.
May be feasible off-pump in select MR+AF cases; leaves open need for prospective trials before wider adoption.
A 67-year-old man with severe mitral regurgitation and paroxysmal atrial fibrillation was admitted to our institution for surgical repair. The procedure was carried out off-pump. We first performed a totally thoracoscopic maze box lesion set with epicardial transmural radiofrequency, and clipped the left atrial appendage. The mitral valve prolapse was repaired by implanting three transapical neochordae. Six months later, the patient was in sinus rhythm with minimal residual mitral regurgitation on echocardiography. This novel approach is less invasive than the standard surgical correction and should ensure a faster recovery with similar safety and efficacy in selected cases.
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Carnero et al. (2020) conducted a case report in Severe mitral regurgitation and paroxysmal atrial fibrillation (n=1). Combined off-pump mitral repair and thoracoscopic maze surgery was evaluated on Sinus rhythm and residual mitral regurgitation on echocardiography. Combined off-pump mitral repair and thoracoscopic maze surgery resulted in sinus rhythm with minimal residual mitral regurgitation at 6 months in a 67-year-old man.
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