Mid-to Long-term Results of Edge to Edge Mitral Repair_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YUWen-da , FANFu-dong , SHAOJun ,  WANGDong-jin

Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, P. R. China;

Corresponding author：

WANGDong-jin, Email: gldjw@163.com

Keywords：

Mitral regurgitation; Mitral valvuloplasty; Double-orifice technique; Edge to edge; Prosthetic mitral ring

DOI：

10.7507/1007-4848.20150003

Video：

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Objective To summarize mid- to long-term results of edge to edge mitral repair for mitral regurgitation (MR). Methods Clinical data of 31 patients who underwent edge to edge mitral repair in Nanjing Drum Tower Hospital from June 2002 to June 2008 were retrospectively reviewed. There were 13 male and 18 female patients with their age of 14-77 (43±21) years. Clinical and echocardiographic data were analyzed. Results Three patients died in hospital,and 28 patients finished mid- to long-term follow-up for 5-10 years. During follow-up, 1 patient died of acute decompensated heart failure in the 2nd year after discharge. Two patients had recurrent moderate MR, and 6 patients had recurrent moderate-to-severe MR including 3 patients who underwent mitral valve replacement in the 5th,6th and 7th postoperative year respectively because of severe MR. Five-year reoperation-free rate was 88.9% (24/27). Five-year mortality was 3.6% (1/28). The incidence of recurrent moderate or severe MR within 5 postoperative years was 28.6% (8/28). Conclusion For complex MR or as an emergency substitute strategy for failed routine mitral valvuloplasty, edgeto- edge mitral repair can produce good mid- to long-term outcomes except for Carpentier Ⅲb MR.

Citation： YUWen-da, FANFu-dong, SHAOJun, WANGDong-jin. Mid-to Long-term Results of Edge to Edge Mitral Repair. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(1): 9-14. doi: 10.7507/1007-4848.20150003 Copy

1.	来永强."缘对缘"技术在瓣膜成形术中的应用. 中华胸心血管外科杂志, 2007, 23(1):1-3.
2.	De Bonis M, Alfieri O. The edge-to-edge technique for mitral valve repair. HSR Proc Intensive Care Cardiovasc Anesth, 2010, 2(1):7-17.
3.	孙海宁, 王巍, 宋云虎, 等. 二尖瓣成形术治疗二尖瓣前叶脱垂的疗效分析. 中国胸心血管外科临床杂志, 2010, 17(4):283-286.
4.	邓学峰, 高长青. 二尖瓣成形术治疗二尖瓣关闭不全. 中国胸心血管外科临床杂志, 2008, 15(2):134-137.
5.	孙广龙, 曹向戎, 张健群. 线圈式人工腱索二尖瓣成形术治疗二尖瓣前叶脱垂的临床分析. 中国胸心血管外科临床杂志, 2013, 20(4):420-424.
6.	陈伟, 张健群, 甘辉立, 等. 腱索折叠与腱索转移矫治二尖瓣前瓣脱垂的比较分析. 中国胸心血管外科临床杂志, 2010, 17(1):26-31.
7.	修宗谊, 谷天祥, 喻磊, 等. 二尖瓣成形术治疗二尖瓣反流89 例临床分析. 中国胸心血管外科临床杂志, 2012, 19(6):676-677.
8.	侯予龙, 沈振亚."双孔"二尖瓣成形术治疗二尖瓣关闭不全 21 例临床分析. 苏州大学学报:医学版, 2009, 29(1):165-166.
9.	刘菁, 卢聪, 黄焕雷, 等. 双孔成形术治疗二尖瓣关闭不全. 岭南心血管病杂志, 2008, 14(1):37-38.
10.	孙凌波, 孟旭, 张纯, 等."缘对缘"二尖瓣成形术治疗二尖瓣前叶脱垂的早中期随访. 中华胸心血管外科杂志, 2008, 24(6):373-375.
11.	马松峰, 乔峻, 木拉提, 等. 双孔二尖瓣成形术后的中长期随访. 心脏杂志, 2008, 20(1):120.
12.	薛清, 韩林, 张冠鑫, 等. 缘对缘瓣叶缝合技术治疗退行性二尖瓣关闭不全的临床分析. 中华外科杂志, 2012, 50(1):32-34.
13.	蒋南青, 张晓膺, 钱永祥, 等. 应用"双孔"技术与 Cosgrove 软质环行二尖瓣成形术. 中国胸心血管外科临床杂志, 2004, 11(4):272.
14.	张纯, 李治安, 王炯. 超声心动图对双孔成形术治疗二尖瓣前叶脱垂的评价. 中国超声医学杂志, 2005, 21(10):751-753.
15.	李进华, 来永强, 王炯等."缘对缘"二尖瓣成形术对左心室舒张功能的影响. 中国胸心血管外科临床杂志, 2009, 16(5):344-347.
16.	潘文明, 舒先红, 洪涛, 等. 超声心动图评价二尖瓣前叶脱垂缘对缘成形术效果. 中华超声影像学杂志, 2009, 18(2):125-127.
17.	金亮, 侯健, 郑勇, 等. 冠状动脉旁路移植同期行二尖瓣成形术治疗缺血性二尖瓣关闭不全. 中国胸心血管外科临床杂志, 2008, 15(4):306-307.
18.	Timek TA, Nielsen SL, Lai DT, et al. Mitral annular size predicts Alfieri stitch tension in mitral edge-to-edge repair. J Heart Valve Dis, 2004, 13(2):165-173.
19.	Timek TA, Nielsen SL, Lai DT, et al. Effect of chronotropy and inotropy on stitch tension in the edge-to-edge mitral repair. Circulation, 2007, 116(11 Suppl):I276-I281.
20.	孟旭, 张红. 双孔成形术治疗二尖瓣前叶脱垂. 中华胸心血管外科杂志, 2003, 19(2):74-76.
21.	李清宝, 董明亮, 李德才, 等. 改良edge-to-edge 二尖瓣成形术治疗成人二尖瓣前叶脱垂的作用. 山东大学学报:医学版, 2012, 50(10):90-92.

1. 来永强."缘对缘"技术在瓣膜成形术中的应用. 中华胸心血管外科杂志, 2007, 23(1):1-3.
2. De Bonis M, Alfieri O. The edge-to-edge technique for mitral valve repair. HSR Proc Intensive Care Cardiovasc Anesth, 2010, 2(1):7-17.
3. 孙海宁, 王巍, 宋云虎, 等. 二尖瓣成形术治疗二尖瓣前叶脱垂的疗效分析. 中国胸心血管外科临床杂志, 2010, 17(4):283-286.
4. 邓学峰, 高长青. 二尖瓣成形术治疗二尖瓣关闭不全. 中国胸心血管外科临床杂志, 2008, 15(2):134-137.
5. 孙广龙, 曹向戎, 张健群. 线圈式人工腱索二尖瓣成形术治疗二尖瓣前叶脱垂的临床分析. 中国胸心血管外科临床杂志, 2013, 20(4):420-424.
6. 陈伟, 张健群, 甘辉立, 等. 腱索折叠与腱索转移矫治二尖瓣前瓣脱垂的比较分析. 中国胸心血管外科临床杂志, 2010, 17(1):26-31.
7. 修宗谊, 谷天祥, 喻磊, 等. 二尖瓣成形术治疗二尖瓣反流89 例临床分析. 中国胸心血管外科临床杂志, 2012, 19(6):676-677.
8. 侯予龙, 沈振亚."双孔"二尖瓣成形术治疗二尖瓣关闭不全 21 例临床分析. 苏州大学学报:医学版, 2009, 29(1):165-166.
9. 刘菁, 卢聪, 黄焕雷, 等. 双孔成形术治疗二尖瓣关闭不全. 岭南心血管病杂志, 2008, 14(1):37-38.
10. 孙凌波, 孟旭, 张纯, 等."缘对缘"二尖瓣成形术治疗二尖瓣前叶脱垂的早中期随访. 中华胸心血管外科杂志, 2008, 24(6):373-375.
11. 马松峰, 乔峻, 木拉提, 等. 双孔二尖瓣成形术后的中长期随访. 心脏杂志, 2008, 20(1):120.
12. 薛清, 韩林, 张冠鑫, 等. 缘对缘瓣叶缝合技术治疗退行性二尖瓣关闭不全的临床分析. 中华外科杂志, 2012, 50(1):32-34.
13. 蒋南青, 张晓膺, 钱永祥, 等. 应用"双孔"技术与 Cosgrove 软质环行二尖瓣成形术. 中国胸心血管外科临床杂志, 2004, 11(4):272.
14. 张纯, 李治安, 王炯. 超声心动图对双孔成形术治疗二尖瓣前叶脱垂的评价. 中国超声医学杂志, 2005, 21(10):751-753.
15. 李进华, 来永强, 王炯等."缘对缘"二尖瓣成形术对左心室舒张功能的影响. 中国胸心血管外科临床杂志, 2009, 16(5):344-347.
16. 潘文明, 舒先红, 洪涛, 等. 超声心动图评价二尖瓣前叶脱垂缘对缘成形术效果. 中华超声影像学杂志, 2009, 18(2):125-127.
17. 金亮, 侯健, 郑勇, 等. 冠状动脉旁路移植同期行二尖瓣成形术治疗缺血性二尖瓣关闭不全. 中国胸心血管外科临床杂志, 2008, 15(4):306-307.
18. Timek TA, Nielsen SL, Lai DT, et al. Mitral annular size predicts Alfieri stitch tension in mitral edge-to-edge repair. J Heart Valve Dis, 2004, 13(2):165-173.
19. Timek TA, Nielsen SL, Lai DT, et al. Effect of chronotropy and inotropy on stitch tension in the edge-to-edge mitral repair. Circulation, 2007, 116(11 Suppl):I276-I281.
20. 孟旭, 张红. 双孔成形术治疗二尖瓣前叶脱垂. 中华胸心血管外科杂志, 2003, 19(2):74-76.
21. 李清宝, 董明亮, 李德才, 等. 改良edge-to-edge 二尖瓣成形术治疗成人二尖瓣前叶脱垂的作用. 山东大学学报:医学版, 2012, 50(10):90-92.

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