Rylski B, Beyersdorf F
Heart Centre Freiburg University, Freiburg, Germany.
Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, USA.
Heart Lung Vessel. 2013;5(4):207-12.
Minimally invasive mitral valve repair is based on several procedural concepts. Recently, three of them have been intensively discussed: aortic occlusion strategy, use of Goretex-Neo-Chordae to repair mitral valve regurgitation and feasibility and efficacy of the minithoracotomy approach in mitral valve treatment of patients after previous cardiac surgery. Twenty years of experience in minimally invasive mitral valve repair have enabled high-volume centers to present valid data and give their recommendations. Transthoracic aortic clamping with ante- and retrograde cardioplegia in the primary setting and hypothermic fibrillation in reoperative setting are currently favoured means of myocardial protection. Neo-chordae concept of mitral valve repair has gained general recognition and has become the technique of choice for many surgeons. The excellent results of minimally invasive mitral valve repair must be considered whenever already available or any new transcatheter techniques are offered.
微创二尖瓣修复基于几个手术概念。最近，其中三个概念受到了深入讨论：主动脉阻断策略、使用戈尔特斯人工新腱索修复二尖瓣反流以及小切口开胸手术方法在既往心脏手术后二尖瓣治疗中的可行性和有效性。20年的微创二尖瓣修复经验使高容量中心能够提供有效数据并给出建议。在初次手术中经胸主动脉阻断并采用顺行和逆行心脏停搏，在再次手术中采用低温颤动，是目前常用的心肌保护方法。二尖瓣修复的人工新腱索概念已得到普遍认可，并已成为许多外科医生的首选技术。无论何时提供现有或任何新的经导管技术，都必须考虑微创二尖瓣修复的出色效果。
