Free Margin Running Suture Repair for Bileaflet Mitral Valve Prolapse in Patients with Left Ventricular Dysfunction: A Mid-term Follow-up Study.

0 CARDIAC & CARDIOVASCULAR SYSTEMS
Alfonso Agnino, Antonio D'Errico Ramirez, Matteo Parrinello, Salvatore Muccio, Amedeo Anselmi, Vito Giovanni Ruggieri
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Abstract

Objectives: Repairing severe mitral regurgitation (MR) in patients with degenerative bileaflet prolapse and reduced left ventricular ejection fraction (LVrEF) is challenging. The Free Margin Running Suture (FMRS) technique offers a non-resectional approach, but mid-term data are limited.

Methods: We analysed 28 patients with bileaflet degenerative MR and LVrEF (≤40%) undergoing FMRS. Primary outcomes were mid-term survival and MR recurrence; secondary outcomes included LVEF, in-hospital complications, transmitral gradient, coaptation length, and mitral valve orifice area.

Results: Mean age was 59.3 ± 12.8 years; 69.4% were male. No perioperative deaths; 1 patient required ECMO. Mean aortic cross-clamp time was 47 ± 18.6 min. Over 4.7 years, survival was 100%, with 1 case of moderate MR recurrence. At follow-up, LVEF improved to 43.04 ± 2.26 (P < 0.001), and all patients were NYHA I-II.

Conclusions: FMRS is a minimally invasive, reproducible technique providing durable repair, symptomatic improvement, and excellent mid-term survival.

Abstract Image

游离缘缝合修复左心功能不全患者双小瓣二尖瓣脱垂的中期随访研究。
目的:修复退行性双小体脱垂和左心室射血分数(LVrEF)降低患者的严重二尖瓣反流(MR)是具有挑战性的。自由边缘运行缝合(FMRS)技术提供了一种非切除方法,但长期数据有限。方法:对28例双肾退行性MR和LVrEF(≤40%)行FMRS的患者进行分析。主要结局是长期生存和MR复发;次要结局包括LVEF、院内并发症、二尖瓣梯度、配合长度和二尖瓣口面积。结果:平均年龄59.3±12.8岁;69.4%为男性。无围手术期死亡;1例患者需要ECMO。平均主动脉交叉钳夹时间为47±18.6 min。4.7年生存率为100%,1例中度MR复发。随访时,LVEF改善至43.04±2.26 (p)。结论:FMRS是一种微创、可重复的技术,可提供持久的修复、症状改善和良好的长期生存。中心信息:自由缘运行缝合(FMRS)技术为左室射血分数降低的双小瓣二尖瓣脱垂患者提供了一种微创、非切除的方法。FMRS具有优异的耐久性,保留心室功能,消除残余反流,导致持续的症状改善,长期生存益处,并适用于机器人辅助修复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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