Endoscopic Mitral Repair for Degenerative Mitral Regurgitation: Effect of Disease Complexity on Short- and Mid-term Outcomes

被引：3
作者：
Hage, Fadi [1 ]
Hage, Ali [1 ]
Manian, Usha [2 ]
Tzemos, Nikolaos [2 ]
Chu, Michael W. A. [1 ,3 ]
机构：
[1] Western Univ, London Hlth Sci Ctr, Dept Surg, Div Cardiac Surg, London, ON, Canada
[2] Western Univ, London Hlth Sci Ctr, Dept Med, Div Cardiol, London, ON, Canada
[3] LHSC, B6-106 Univ Hosp,339 Windermere Rd, London, ON N6A 5A5, Canada
来源：
CJC OPEN | 2020年 / 2卷 / 05期
关键词：
D O I：
10.1016/j.cjco.2020.04.005
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Background: We set out to compare in a prospective cohort study the mid-term clinical and echocardiographic outcomes of mini-mitral repair for simple (posterior prolapse) vs complex regurgitation (anterior/bileaflet prolapse). Methods: A total of 245 consecutive patients underwent mini-mitral repair for severe degenerative mitral regurgitation through a right, endoscopic approach (n = 145 simple, n = 100 complex). The most common repair technique was annuloplasty + artificial chordae (84%, n = 121 for simple vs 88%, n = 88 for complex, P = 0.3). Patients were prospectively followed for a maximal duration of 9 years. Patients' characteristics were well balanced between groups. Results: The 30-day/in-hospital mortality was similar (0%, n = 0 simple vs 1%, n = 1 complex, P = 0.2). Both groups had similar rates of early postoperative complications: myocardial infarction (1.4%, n = 2 vs 0%, n = 0, P = 0.2), neurologic complications (1.4%, n = 2 vs 0%, n = 0, P = 0.2), reoperation for bleeding (0.7%, n = 1 vs 3%, n = 3, P = 0.2), intensive care unit length of stay (1 interquartile range, 1-1 days vs 1 interquartile range, 1-1 days, P = 0.7). Late survival (88% for simple vs 92% for complex, P = 0.4) was similar between groups. Cumulative incidence of late reoperation at 6 years is 0% for both groups (subdistribution hazard ratio = 1, P = 1). There was no dif-ference in recurrent mitral regurgitation greater than 2+ at each year after surgery up to 6 years postoperatively. Conclusion: Mitral repair using an endoscopic, minimally invasive approach yields excellent mid-term outcomes regardless of disease complexity.
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收藏
页码：337 / 343
页数：7
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