Herz und Gefäß Klinik, Salzburger Leite 1, 97616 Bad Neustadt/Saale, Germany.
Ann Cardiothorac Surg. 2013 Nov;2(6):751-7. doi: 10.3978/j.issn.2225-319X.2013.10.12.
Valve repair has been shown to be the method of choice in the treatment of patients with severe mitral valve regurgitation. Minimally invasive surgery has raised skepticism regarding the rate of repair especially for supposedly complex lesions, when anterior leaflet involvement or bileaflet prolapse is present. We sought to review our experience of all our patients presenting with degenerative mitral valve regurgitation and operated on minimally invasively.
From September 2006 to December 2012, 842 patients (mean age 56.12±11.62 years old) with degenerative mitral valve regurgitation and anterior leaflet (n=82, 9.7%), posterior leaflet (n=688, 81.7%) and bileaflet (n=72, 8.6%) prolapses were operated on using a minimally invasive approach.
836 patients had a valve repair (99.3%) and received a concomitant ring annuloplasty (mean size, 33.7; range, 28-40). Six patients (0.7%) underwent valve replacement. Two patients had a re-repair due to MR progression or infective endocarditis. Thirty-day mortality was 0.2% (two patients). There were 60 major adverse events (MAE) (7.1%).
A minimally invasive approach allows repair of almost all degenerative valves with good short-term outcomes in a tertiary referral center, when using proven and efficient surgical techniques.
瓣膜修复已被证明是治疗严重二尖瓣反流患者的首选方法。微创手术对修复率提出了质疑，尤其是对于存在前瓣受累或双瓣叶脱垂的所谓复杂病变。我们旨在回顾我们所有接受退行性二尖瓣反流微创治疗的患者的经验。
从 2006 年 9 月至 2012 年 12 月，842 例退行性二尖瓣反流患者（平均年龄 56.12±11.62 岁）接受了微创二尖瓣修复术，其中前瓣叶受累（n=82，9.7%），后瓣叶受累（n=688，81.7%）和双瓣叶脱垂（n=72，8.6%）。
836 例患者行瓣膜修复（99.3%），同期行环瓣成形术（平均直径 33.7mm；范围 28-40mm）。6 例（0.7%）行瓣膜置换术。2 例因 MR 进展或感染性心内膜炎再次修复。30 天死亡率为 0.2%（2 例）。共有 60 例重大不良事件（MAE）（7.1%）。
在三级转诊中心，采用成熟有效的手术技术，微创方法可修复几乎所有退行性瓣膜，获得良好的短期结果。
