Minimally invasive papillary muscle sling placement during mitral valve repair in patients with functional mitral regurgitation
| Autor: | Orlando Santana, Christos G. Mihos, Natalia V. Solenkova, Joseph Lamelas, Andres M. Pineda |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Mitral Valve Annuloplasty Time Factors medicine.medical_treatment Severity of Illness Index Ventricular Function Left law.invention Postoperative Complications Risk Factors Interquartile range law Internal medicine Mitral valve medicine Cardiopulmonary bypass Humans Thoracotomy Papillary muscle Aged Retrospective Studies Ultrasonography Heart Valve Prosthesis Implantation Mitral valve repair Mitral regurgitation Cardiopulmonary Bypass Ejection fraction business.industry Mitral Valve Insufficiency Stroke Volume Length of Stay Middle Aged Papillary Muscles Surgery Treatment Outcome medicine.anatomical_structure Cardiology Feasibility Studies Mitral Valve Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 147:496-499 |
| ISSN: | 0022-5223 |
| Popis: | Background We evaluated the safety and feasibility of minimally invasive mitral valve repair with papillary muscle sling placement via a right anterior thoracotomy approach in patients with severe functional mitral regurgitation (MR). Methods We retrospectively reviewed all minimally invasive mitral valve repairs with papillary muscle sling placement in patients with severe functional MR performed at our institution between October 2011 and September 2012. The operative times, lengths of stay, postoperative complications, and mortality were analyzed. Results We identified a total of 19 consecutive patients. There were 12 men (63%); the mean age was 60 ± 13 years. The mean ± SD left ventricular ejection fraction was 23% ± 5.5%, and 4 (21%) of the patients underwent previous coronary artery bypass graft surgery. The median aortic cross-clamp and cardiopulmonary bypass times were 106 (interquartile range [IQR], 76-120) and 163 (IQR, 119-170) minutes, respectively. The median intensive care unit length of stay was 64 (IQR, 43-75) hours, and the median postoperative length of stay was 7 (IQR, 5-7.5) days. Postoperatively, 2 patients developed acute kidney injury. There were no reoperations for bleeding or any cerebrovascular accidents. The 30-day mortality was 0. A follow-up echocardiogram, obtained at a median of 3 (IQR, 1-7.5) months, demonstrated none to trivial MR in all patients. Conclusions Minimally invasive mitral repair with papillary muscle sling placement for severe functional MR is safe and effective in the short-term. Long-term data are needed to evaluate the effects on left ventricular remodeling and to assess the durability of the repair. |
| Databáze: | OpenAIRE |
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