Early clinical outcomes of thoracoscopic mitral valvuloplasty: a clinical experience of 100 consecutive cases
10.3760/cma.j.cn112434-20200617-00298
- VernacularTitle:连续100例胸腔镜二尖瓣成形术早期临床结果分析
- Author:
Huimin CUI
1
;
Lin ZHANG
;
Shixiong WEI
;
Lianggang LI
;
Tong REN
;
Shengli JIANG
Author Information
1. 中国人民解放军总医院第一医学中心心血管外科，北京 100853
- Keywords:
Thoracoscopy;
Minimally invasive surgical procedures;
Mitral valvuloplasty
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(9):542-545
- CountryChina
- Language:Chinese
-
Abstract:
Objective: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 of thoracoscopic mitral valvuloplasty had been completed in our institution. There were 56 males and 44 females. The mean age was(49.2±14.7) years old, ranging from 15 to 75 years old.The safety and feasibility of this technique was evaluated by its early clinical outcomes.Results:Mitral valve(MV) repair techniques included leaflet folding in 5 cases, cleft suture in 10, commissuroplasty in 15, edge to edge in 1, artificial chordae implantation in 76 cases with mean of(2.5±1.6)(1-4) 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 after being blocked again. The mean 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 )min and(96.3±25.4) min, the difference was statistically significant( P<0.05). There was one operative death for avulsion of left atrial suture after operation and 2 intraoperative re-exploration for bleeding. Severe MR was observed in 2 patients 3 months after operation, and mitral valve replacement(MVR) was performed through median sternotomy. Conclusion:Totally thoracoscopic mitral valvuloplasty is technically feasible, safe, effective and reproducible in clinical practice after crossing the learning curve. The short-term effect is satisfactory, however, further randomized and long-term follow-up studies are warranted to determine its clinical effects.
