Early clinical outcomes of totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty for mitral regurgitation in Barlow disease / 中华胸心血管外科杂志

ABSTRACT

Objective:To confirm the safety and feasibility of totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty for mitral regurgitation(MR) in Barlow disease.Methods:From June 2018 to December 2019, 10 consecutive Barlow’s disease patients underwent totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its early clinical outcomes.Results:8 males and 2 females. The mean age was(33.5±11.0) years.There was no operative death and related complications. The mean cardiopulmonary bypass(CPB) time was(142±26)(112-194)min, and the aortic clamping time was(96±18)(78-128) min. The average number of artificial chordae implantation was(3.4±0.7)(2-4) pairs/case. Intraoperative transesophageal echocardiography(TEE) showed the mean mitral valve coaptation length and transvalvular pressure gradient was(1.2±0.2)(0.8-1.5) cm and(1.2±0.4) mmHg(1 mmHg=0.133 kPa), respectively, without MR or systolic anterior motion(SAM). During a follow-up of 1-18 months, there were 7 cases with no MR and 3 with trace MR, with a mean transvalvular pressure gradient of( 1.5±0.6 )mmHg.Conclusion:Totally thoracoscopic repair with leaflet folding, multiple artificial chordae implantation and ring annuloplasty was a safe and effective procedure with satisfied early clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.