Nakamura Ryota, Nakanaga Hiroshi, Fujii Hiromi, Tatsuki Suguru, Ota Mitsuhiko, Tabata Minoru
Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Interdiscip Cardiovasc Thorac Surg. 2023 Jun 1;36(6). doi: 10.1093/icvts/ivad084.
We aimed to evaluate the mid-term clinical and echocardiographic outcomes of chordal foldoplasty performed for non-resectional mitral valve repair in degenerative mitral valve disease with a large posterior leaflet.
We reviewed 82 patients undergoing non-resectional mitral valve repair via chordal foldoplasty between October 2013 and June 2021. We analysed operative outcomes, mid-term survival rate, freedom from reoperation and freedom from recurrent moderate or severe mitral regurgitation (MR).
The mean age of patients was 57.2 ± 12.4 years; 61 patients (74%) had posterior leaflet prolapse, 21 patients (26%) had bileaflet prolapse and all of them had at least 1 tall posterior leaflet scallop. Minimally invasive approach with a right mini-thoracotomy was used in 73 patients (89%). The operative mortality was zero. There was no conversion to mitral valve replacement and postoperative echocardiography revealed no more than mild residual regurgitation or systolic anterior motion. Five-year survival rate, freedom from mitral reoperation and freedom from recurrent moderate/severe MR were 93.9%, 97.4% and 94.5%, respectively.
Non-resectional chordal foldoplasty is a simple and effective repair technique for select degenerative MR cases with a tall posterior leaflet.
我们旨在评估在具有大后叶的退行性二尖瓣疾病中，采用腱索折叠术进行非切除性二尖瓣修复的中期临床和超声心动图结果。
我们回顾了2013年10月至2021年6月期间通过腱索折叠术进行非切除性二尖瓣修复的82例患者。我们分析了手术结果、中期生存率、再次手术自由度以及无复发性中度或重度二尖瓣反流（MR）的情况。
患者的平均年龄为57.2±12.4岁；61例患者（74%）有后叶脱垂，21例患者（26%）有双叶脱垂，且所有患者至少有1个高后叶扇贝。73例患者（89%）采用了右胸小切口的微创方法。手术死亡率为零。没有转为二尖瓣置换术，术后超声心动图显示残留反流不超过轻度或无收缩期前向运动。五年生存率、无二尖瓣再次手术率和无复发性中度/重度MR率分别为93.9%、97.4%和94.5%。
对于特定的具有高后叶的退行性MR病例，非切除性腱索折叠术是一种简单有效的修复技术。
