The mid-long term results of application research of artificial Gore-Tex chordate in mitral valvuloplasty in patients with infective endocarditis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Qiang , WANG Zhigang , LI Kai ,  WANG Dongjin

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

Corresponding author：

WANG Dongjin, Email: gldjw@163.com

Keywords：

Mitral valvuloplasty; mitral regurgitation; artificial chordae tendineae

DOI：

10.7507/1007-4848.201609025

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Objective To evaluate the mid-long term results of application research of artificial Gore-Tex chordate in mitral valvuloplasty in patients with mitral insufficiency caused by endocarditis. Methods We retrospectively analyzed the clinical data of 28 consecutive infective endocarditis(IE) patients who received mitral valve repair with Gore-Tex in our hospital between January 2012 and December 2015. There were 17 males and 11 females. The age of these patients ranged from 18 to 69 (52.0±15.4) years. Echocardiography before operation showed the degree of mitral regurgitation (MR) was severe in 19 patients, moderate in 9 patients. Six patients were in New York Heart Association (NYHA) class Ⅱ, 14 in class Ⅲ, 8 in class Ⅳ. There were 26 selective surgeries and 2 emergent surgeries. One patient had concomitant coronary artery bypass graft. Six patients had aortic valve replacement. Five patients had aortic valve repair. Twenty patients had tricuspid valve repair. Five patients had Maze procedure. Results Follow-up was done to all the patients for 6 months to 55 (30.5±6.4) months. During the follow-up, the echocardiography showed that postoperative left atrium diameter (36.64±8.50 mm vs. 51.78±17.50 mm, P<0.05) and left ventricular end-diastolic dimension (49.30±5.05 mmvs. 57.70±7.49 mm, P<0.05) were significantly smaller than those before operation. The left ventricular ejection fraction (EF) increased from 53.86%±8.16% to 59.14%±4.23% (P<0.05). No MR was found in 16 patients, mild MR in 8 patients, mild to moderate MR in 2 patients, moderate MR in 1 patient. One patient required reoperation for recurrent infection. No death or complications related to thrombosis and embolism occurred after operation. Conclusion Application research of artificial Gore-Tex chordate in mitral valve repair is feasible for treating mitral valve lesions caused by endocarditis, and may provide a long-term outcome to the patients.

Citation： WANG Qiang, WANG Zhigang, LI Kai, WANG Dongjin. The mid-long term results of application research of artificial Gore-Tex chordate in mitral valvuloplasty in patients with infective endocarditis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(12): 979-982. doi: 10.7507/1007-4848.201609025 Copy

1.	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.
2.	De Bonis M, Lorusso R, Lapenna E, et al. Similar long-term results of mitral valve repair for anterior compared with posterior leaflet prolapse. J Thorac Cardiovasc Surg, 2006, 131(2): 364-370.
3.	Salvador L, Mirone S, Bianchini R, et al. A 20-year experience with mitral valve repair with artificial chordae in 608 patients. J Thorac Cardiovasc Surg, 2008, 135(6): 1280-1287.
4.	Yousefnia MA, Roshanali F, Mandegar MH. Results of mitral valve repair in rheumatic mitral regurgitation. Interact Cardiovasc Thorac Surg, 2006, 5(4): 361.
5.	Ruttmann E, Legit C, Poelzl G, et al. Mitral valve repair provides improved outcome over replacement in active infective endocarditis. J Thorac Cardiovasc Surg, 2005, 130(3): 765-771.
6.	Shimokawa T, Kasegawa H, Matsuyama S, et al. Long-term outcome of mitral valve repair for infective endocarditis. Ann Thorac Surg, 2009, 88(3): 733-739.
7.	Yamaguchi H, Eishi K, Yamachika S, et al. Mitral valve repair in patients with infective endocarditis. Circ J, 2006, 70(2): 179-183.
8.	Zegdi R, Debièche M, Latrémouille C, et al. Long-term results of mitral valve repair in active endocarditis. Circulation, 2005, 111(19): 2532-2536.
9.	Feringa HH, Shaw LJ, Poldermans D, et al. Mitral valve repair and replacement in endocarditis: a systematic review of literature. Ann Thorac Surg, 2007, 83(2): 564-570.
10.	Gammie JS, O'Brien SM, Griffith BP, et al. Surgical treatment of mitral valve endocarditis in North America. Ann Thorac Surg, 2005, 80(6): 2199-2204.
11.	Hisatomi K, Yamada T, Odate T, et al. Mitral valve repair during acute phase infective endocarditis with extensive destruction of the anterior leaflet rough zone and cerebral infarction. Gen Thorac Cardiovasc Surg, 2012, 60(8): 507-510.
12.	Bortolotti U, Milano AD, Frater RW. Mitral valve repair with artificial chordae: a review of its history, technical details, long-term results, and pathology. Ann Thorac Surg, 2012, 93(2): 684-691.
13.	Yamaguchi H, Eishi K. Surgical treatment of active infective mitral valve endocarditis. Ann Thorac Cardiovasc Surg, 2007, 13(3): 150-155.
14.	Delmo WEM, Musci M, Nagdyman N, et al. Mitral valve repair for infective endocarditis in children. Ann Thorac Surg, 2007, 84(6): 2059-2065.
15.	Frater RW, Vetter HO, Zussa C, et al. Chordal replacement in mitral valve repair. Circulation, 1990, 82(5 Suppl): IV125-130.
16.	Hata H, Fujita T, Shimahara Y, et al. A 25-year study of chordal replacement with expanded polytetrafluoroethylene in mitral valve repair†. Interact Cardiovasc Thorac Surg, 2015, 20(4): 463-468.
17.	Kobayashi J, Sasako Y, Bando K, et al. Ten-year experience of chordal replacement with expanded polytetrafluoroethylene in mitral valve repair. Circulation, 2000, 102(19 Suppl 3): Ⅲ30-Ⅲ34.
18.	Alvarez JM, Deal CW, Loveridge K, et al. Repairing the degenerative mitral valve: ten- to fifteen-year follow-up. J Thorac Cardiovasc Surg, 1996, 112(2): 238-247.
19.	David TE, Armstrong S, Sun Z, et al. Late results of mitral valve repair for mitral regurgitation due to degenerative disease. Ann Thorac Surg, 1993, 56(1): 7-14.
20.	Cohn LH, Couper GS, Aranki SF, et al. Long-term results of mitral valve reconstruction for regurgitation of the myxomatous mitral valve. J Thorac Cardiovasc Surg, 1994, 107(1): 143-151.

1. 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.
2. De Bonis M, Lorusso R, Lapenna E, et al. Similar long-term results of mitral valve repair for anterior compared with posterior leaflet prolapse. J Thorac Cardiovasc Surg, 2006, 131(2): 364-370.
3. Salvador L, Mirone S, Bianchini R, et al. A 20-year experience with mitral valve repair with artificial chordae in 608 patients. J Thorac Cardiovasc Surg, 2008, 135(6): 1280-1287.
4. Yousefnia MA, Roshanali F, Mandegar MH. Results of mitral valve repair in rheumatic mitral regurgitation. Interact Cardiovasc Thorac Surg, 2006, 5(4): 361.
5. Ruttmann E, Legit C, Poelzl G, et al. Mitral valve repair provides improved outcome over replacement in active infective endocarditis. J Thorac Cardiovasc Surg, 2005, 130(3): 765-771.
6. Shimokawa T, Kasegawa H, Matsuyama S, et al. Long-term outcome of mitral valve repair for infective endocarditis. Ann Thorac Surg, 2009, 88(3): 733-739.
7. Yamaguchi H, Eishi K, Yamachika S, et al. Mitral valve repair in patients with infective endocarditis. Circ J, 2006, 70(2): 179-183.
8. Zegdi R, Debièche M, Latrémouille C, et al. Long-term results of mitral valve repair in active endocarditis. Circulation, 2005, 111(19): 2532-2536.
9. Feringa HH, Shaw LJ, Poldermans D, et al. Mitral valve repair and replacement in endocarditis: a systematic review of literature. Ann Thorac Surg, 2007, 83(2): 564-570.
10. Gammie JS, O'Brien SM, Griffith BP, et al. Surgical treatment of mitral valve endocarditis in North America. Ann Thorac Surg, 2005, 80(6): 2199-2204.
11. Hisatomi K, Yamada T, Odate T, et al. Mitral valve repair during acute phase infective endocarditis with extensive destruction of the anterior leaflet rough zone and cerebral infarction. Gen Thorac Cardiovasc Surg, 2012, 60(8): 507-510.
12. Bortolotti U, Milano AD, Frater RW. Mitral valve repair with artificial chordae: a review of its history, technical details, long-term results, and pathology. Ann Thorac Surg, 2012, 93(2): 684-691.
13. Yamaguchi H, Eishi K. Surgical treatment of active infective mitral valve endocarditis. Ann Thorac Cardiovasc Surg, 2007, 13(3): 150-155.
14. Delmo WEM, Musci M, Nagdyman N, et al. Mitral valve repair for infective endocarditis in children. Ann Thorac Surg, 2007, 84(6): 2059-2065.
15. Frater RW, Vetter HO, Zussa C, et al. Chordal replacement in mitral valve repair. Circulation, 1990, 82(5 Suppl): IV125-130.
16. Hata H, Fujita T, Shimahara Y, et al. A 25-year study of chordal replacement with expanded polytetrafluoroethylene in mitral valve repair†. Interact Cardiovasc Thorac Surg, 2015, 20(4): 463-468.
17. Kobayashi J, Sasako Y, Bando K, et al. Ten-year experience of chordal replacement with expanded polytetrafluoroethylene in mitral valve repair. Circulation, 2000, 102(19 Suppl 3): Ⅲ30-Ⅲ34.
18. Alvarez JM, Deal CW, Loveridge K, et al. Repairing the degenerative mitral valve: ten- to fifteen-year follow-up. J Thorac Cardiovasc Surg, 1996, 112(2): 238-247.
19. David TE, Armstrong S, Sun Z, et al. Late results of mitral valve repair for mitral regurgitation due to degenerative disease. Ann Thorac Surg, 1993, 56(1): 7-14.
20. Cohn LH, Couper GS, Aranki SF, et al. Long-term results of mitral valve reconstruction for regurgitation of the myxomatous mitral valve. J Thorac Cardiovasc Surg, 1994, 107(1): 143-151.

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The mid-long term results of application research of artificial Gore-Tex chordate in mitral valvuloplasty in patients with infective endocarditis

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