Five-year comparative outcomes of the track technique versus conventional artificial chordae sizing in anterior mitral leaflet repair.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2025-09-09 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1642204

Giuseppe Nasso, Walter Vignaroli, Raffaele Bonifazi, Giovanni Valenti, Flavio Fiore, Dritan Hila, Tommaso Loizzo, Rosalba Franchino, Antongiulio Valenzano, Giacomo Errico, Vincenza Vitobello, Giuseppe Balducci, Giacomo Schinco, Felice Agrò, Mario Siro Brigiani, Cataldo Girasoli, Guido Lembo, Ernesto Greco, Gaetano Contegiacomo, Giuseppe Santarpino, Giuseppe Speziale

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Abstract

Introduction: Determining artificial chordae length is crucial for successful mitral valve repair (MVr). This study evaluates five-year outcomes of a novel "track technique", which uses an annular guiding device for chordal length adjustment, compared to a conventional approach.

Methods: A retrospective analysis was conducted on 47 patients who underwent MVr with artificial chordae: 25 received the track technique, and 22 underwent conventional chordal sizing. All patients received complete annuloplasty and were followed for five years. The primary endpoint was freedom from moderate or severe mitral regurgitation (MR); secondary endpoints included NYHA class, coaptation length, freedom from reintervention, and all-cause mortality.

Results: At five years, neither group showed moderate/severe MR or required reoperation. However, the track group showed superior outcomes: significantly longer coaptation length (10.7 ± 1.5 mm vs. 8.6 ± 1.8 mm, p = 0.03) and lower residual MR (12% vs. 32%, p = 0.04). More than 90% of patients in both groups were in NYHA class I-II.

Discussion: In conclusion, the track technique is a safe, effective, and reproducible method for artificial chordae sizing in MVr. It ensures better leaflet coaptation, reduces residual MR, and maintains favorable clinical results over a five-year period.

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在二尖瓣前叶修复中，径迹技术与传统人工索固定的5年比较结果。

人工索长度的确定是二尖瓣修复（MVr）成功的关键。与传统方法相比，本研究评估了一种新型“轨道技术”的5年效果，该技术使用环形导向装置进行弦长调整。方法：回顾性分析47例行人工脊索MVr的患者，其中25例采用轨迹技术，22例采用常规脊索缩小术。所有患者均接受完整的环成形术，随访5年。主要终点为无中度或重度二尖瓣反流（MR）；次要终点包括NYHA分级、适应长度、免于再干预和全因死亡率。结果：在5年时，两组均未出现中度/重度MR或需要再次手术。然而，田径组表现出更好的结果：明显更长的覆盖长度（10.7±1.5 mm比8.6±1.8 mm, p = 0.03）和更低的残余MR（12%比32%，p = 0.04）。两组患者均超过90%为NYHA I-II级。讨论：综上所述，轨迹技术是一种安全、有效、可重复的MVr人工索定型方法。它确保更好的小叶适应，减少残余MR，并在5年期间保持良好的临床结果。

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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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.