Total thoracoscopic valvuloplasty of Barlow disease: outcomes of ten-year follow-up
10.3760/cma.j.cn112434-20250117-00015
- VernacularTitle:全腔镜Barlow病修复：十年随访结果
- Author:
Zhaolong ZHANG
1
;
Lishan ZHONG
;
Yuxin LI
;
Qiuji WANG
;
Shanwen PANG
;
Junqiang QIU
;
Linbin HUA
;
Yingjie KE
;
Huanlei HUANG
Author Information
1. 广东省心血管病研究所 广东省人民医院 广东省医学科学院心外科，广州 510080
- Publication Type:Journal Article
- Keywords:
Barlow disease;
Mitral valvuloplasty;
Total thoracoscopic minimally invasive surgery;
Mitral regurgitation
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(6):352-358
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To clarify the safety, repair rate, durability, and risk factors for recurrent mitral regurgitation(MR) in patients with Barlow disease(BD) who total thoracoscopic minimally invasive mitral valvuloplasty(TMVP).Methods:Clinical data, mid-term and long-term outcomes of BD patients who underwent TMVP at Guangdong Provincial People's Hospital from January 2009 to June 2022 were retrospectively analyzed. Patients were divided into a group with no MR recurrence(group A) and a group with MR recurrence(group B) according to whether recurrent MR appeared in the postoperative period, and the data of the two groups of patients were compared with each other for the risk factor analysis.Results:The repair rate of TMVP was 98.4%, and no patient died perioperatively. The median follow-up time was 3.1(1.7, 5.2) years, the follow-up rate was 95.8%, and there was no patient died. As of March 2023, 112 patients developed no recurrent MR(group A), 11 patients developed recurrent MR(group B), and 2 patients in group B underwent repeated mitral valve surgery. The left atrial diameter(LAD) and left ventricular end-systolic diameter(LVESD) were higher in group B than in group A patients[LAD: (50.9±7.7)mm vs.(43.7±8.7)mm, P=0.009; LVESD: (37.1±5.5)mm vs.(33.2±4.7)mm, P=0.011], and the percentage of tendon cord rupture was higher in group B than in group A( P=0.022), while the rest of the baseline data were not statistically significant. There was no statistically significant difference between two groups in terms of the use of different surgical techniques, aortic cross-clamp time, cardiopulmonary bypass time, and operative time. Postoperative LAD, postoperative LVESD, and postoperative left ventricular end-diastolic diameter of group B patients were higher than those of group A( P<0.05). There was no statistically significant difference in perioperative and long-term complication rates between the two groups. Multifactorial Cox regression analysis revealed that advanced age( HR=1.049, 95% CI: 0.997-1.103, P=0.066) and large preoperative LVESD( HR=1.168, 95% CI: 1.053-1.295, P=0.003) were the risk factors for postoperative recurrence MR. Conclusion:Total thoracoscopic minimally invasive BD repair is safe, which has a high success rate and good long-term results. Advanced age and large preoperative LVESD are risk factors for recurrent MR in the long term.
