Minimally Invasive Mitral Valve Surgery for Rheumatic Valve Disease
DOI:
https://doi.org/10.1532/hsf.2529Abstract
Background: The development of minimally invasive mitral valve surgery has created the motivation for using this approach in young patients with chronic rheumatic valve disease. We report our recent experience with patients undergoing minimally mitral valve surgery in this group of patients.
Methods: Between July 2014 and June 2018, 142 patients with rheumatic mitral valve dysfunction underwent minimally invasive surgery through a right thoracotomy approach at the University Medical Center of Ho Chi Minh City in Vietnam. Diagnosis was confirmed with transthoracic and transesophageal echocardiography (TTE and TEE). We analyzed the in-hospital and midterm follow-up outcomes of this group.
Results: The mean age was 42.6 ± 9.6 years. Sixty patients (42.3%) were male. Sixty-three patients were diagnosed with functional severe tricuspid regurgitation, 29 patients were identified with moderate tricuspid regurgitation, and tricuspid annulus was more than 21 mm/m²). Mitral valve repair was performed in 16 patients (11.3%), and 126 patients underwent mitral valve replacement. Mitral valve repair techniques included annuloplasty, leaflet peeling, and commissurotomy. Thirty-day mortality was 0.7%. Two patients had to be converted to conventional sternotomy, due to left atrial appendage laceration and mitral annular rupture. The overall survival rate was 98.6%. Freedom from reoperation was 97.1%.
Conclusions: In patients with rheumatic valve disease, minimally invasive mitral surgery safely and effectively can be performed with few perioperative complications and good midterm results.
References
Cheng DC, Martin J, Lal A, Diegeler A, Folliguet TA, Nifong LW, et al. 2011. Minimally invasive versus conventional open mitral valve surgery: a meta-analysis and systematic review. Innovations (Phila). 6(2):84-103.
Chopra HK, Nanda NC, Fan P, Kapur KK, Goyal R, Daruwalla D, et al. 1989. Can two-dimensional echocardiography and Doppler color flow mapping identify the need for tricuspid valve repair? J Am Coll Cardiol. 14(5):1266-74.
Chotivatanapong T, Lerdsomboon P, Sungkahapong V. 2012. Rheumatic mitral valve repair: experience of 221 cases from Central Chest Institute of Thailand. J Med Assoc Thai. 95 Suppl 8:S51-7.
Ding C, Jiang DM, Tao KY, Duan QJ, Li J, Kong MJ, et al. 2014. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis. J Zhejiang Univ Sci B. 15(6):522-32.
Glauber M, Miceli A, Canarutto D, Lio A, Murzi M, Gilmanov D, et al. 2015. Early and long-term outcomes of minimally invasive mitral valve surgery through right minithoracotomy: a 10-year experience in 1604 patients. J Cardiothorac Surg. 10:181.
Jaine R, Baker M, Venugopal K. 2008. Epidemiology of acute rheumatic fever in New Zealand 1996-2005. J Paediatr Child Health. 44(10):564-71.
Lamelas J. 2015. Concomitant minithoracotomy aortic and mitral valve surgery: the minimally invasive "Miami Method". Ann Cardiothorac Surg. 4(1):85-7.
Luca F, van Garsse L, Rao CM, Parise O, La Meir M, Puntrello C, et al. 2013. Minimally invasive mitral valve surgery: a systematic review. Minim Invasive Surg. 179569.
Misfeld M, Borger M, Byrne JG, Chitwood WR, Cohn L, Galloway A, et al. 2013. Cross-sectional survey on minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2(6):733-8.
Modi P, Chitwood WR, Jr. 2013. Retrograde femoral arterial perfusion and stroke risk during minimally invasive mitral valve surgery: is there cause for concern? Ann Cardiothorac Surg. 2(6):E1.
Murzi M, Cerillo AG, Miceli A, Bevilacqua S, Kallushi E, Farneti P, et al. 2013. Antegrade and retrograde arterial perfusion strategy in minimally invasive mitral-valve surgery: a propensity score analysis on 1280 patients. Eur J Cardiothorac Surg. 43(6):e167-72.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, 3rd, Guyton RA, et al. 2014. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 148(1):e1-e132.
Pfannmuller B, Davierwala P, Hirnle G, Borger MA, Misfeld M, Garbade J, et al. 2013. Concomitant tricuspid valve repair in patients with minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2(6):758-64.
Rozich JD, Carabello BA, Usher BW, Kratz JM, Bell AE, Zile MR. 1992. Mitral valve replacement with and without chordal preservation in patients with chronic mitral regurgitation. Mechanisms for differences in postoperative ejection performance. Circulation. 86(6):1718-26.
Schaff HV. 2015. Mitral valve repair in patients with rheumatic heart disease: what are the limits? J Thorac Cardiovasc Surg. 149(3):779-80.
Seeburger J, Borger MA, Falk V, Kuntze T, Czesla M, Walther T, et al. 2008. Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients. Eur J Cardiothorac Surg. 34(4):760-5.
Sharma U, Tak T. 2011. Aortic atheromas: current knowledge and controversies: a brief review of the literature. Echocardiography. 28(10):1157-63.
Steer AC, Kado J, Jenney AW, Batzloff M, Waqatakirewa L, Mulholland EK, et al. 2009. Acute rheumatic fever and rheumatic heart disease in Fiji: prospective surveillance, 2005-2007. Med J Aust. 190(3):133-5.
Wang Z, Zhou C, Gu H, Zheng Z, Hu S. 2013. Mitral valve repair versus replacement in patients with rheumatic heart disease. J Heart Valve Dis. 22(3):333-9.
World Health Organ Tech Rep Ser. 2004. Rheumatic fever and rheumatic heart disease. 923:1-122, back cover.
Published
How to Cite
Issue
Section
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).
