eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
4/2019
vol. 15
 
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abstract:
Original paper

Comparison of early postoperative results between conventional and transapical mitral valve repair

Aleksejus Zorinas
1
,
Artūras Lipnevicius
1
,
Viktorija Bleizgytė
1
,
Vilius Janušauskas
1
,
Daina Liekienė
1
,
Mindaugas Budra
1
,
Robertas Stasys Samalavičius
2
,
Agnė Drąsutienė
1
,
Diana Zakarkaitė
1
,
Audrius Aidietis
1
,
Kęstutis Ručinskas
1

1.
Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania
2.
Centre of Anaesthesia, Intensive Care, and Pain Management, Department of Intensive Care, Vilnius University, Vilnius, Lithuania
Adv Interv Cardiol 2019; 15, 4 (58): 439–445
Online publish date: 2019/12/08
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Introduction
Conventional mitral valve repair (CMVR) is well-established, safe and effective treatment for degenerative mitral regurgitation (MR). Transapical off-pump implantation of artificial chordae (TA) has been introduced into practice and gained interest among surgeons. However, there are no publications comparing the results between TA and CMVR.

Aim
To compare early postoperative outcomes of CMVR with TA in patients with degenerative MR.

Material and methods
This was a retrospective cohort study. A total of 169 patients who underwent mitral valve repair between 2011 and 2018 were included in this analysis. Patients were divided into two groups: the TA group, n = 78 and CMVR group, n = 91. The groups were compared for early postoperative outcomes.

Results
Patients in the TA group were younger, 54.2 ±11.1 vs. 59.5 ±12.8 years (p = 0.005). Patients in the CMVR group had more complicated postoperative course with higher incidence of blood transfusion (42.9% vs. 7.8%, p = 0.001), atrial fibrillation (25.3% vs. 11.7%, p = 0.031), renal insufficiency (15.4% vs. 2.6%, p = 0.007) and stroke (2.1% vs. 0%). In the early postoperative period, one patient died in the TA group, and there were no deaths in the CMVR group (p = 0.277). Residual moderate to severe mitral regurgitation was present in nine (11.5%) TA patients, while none of the patients in the CMVR group had moderate or a higher degree of residual regurgitation (p = 0.001).

Conclusions
Off-pump transapical MV repair is a feasible and safe procedure with low postoperative morbidity rates. Higher rates of mitral regurgitation reoccurrence would require a careful and thorough selection of the patients suitable for the TA approach.

keywords:

minimally invasive surgery, mitral regurgitation, transapical mitral valve repair

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