Application of Chimney technique in mitral valve reoperation: A retrospective study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Wenhao , SONG Laichun , YANG Mingyuan , WU Jingcheng ,  TAO Liang

Department of Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan University, Wuhan, 430000, P. R. China;

Corresponding author：

TAO Liang, Email: taoliangmd@sina.com

Keywords：

Heart valve disease; prosthesis-patient mismatch; reoperation; mitral valve replacement; Chimney technique

DOI：

10.7507/1007-4848.202210036

Video：

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Objective To investigate and evaluate the safety and effectiveness of the Chimney technique in mitral valve reoperation. Methods The clinical data of mitral valve reoperation patients who underwent Chimney surgery in Wuhan Asia Heart Hospital from 2019 to 2021 were retrospectively analyzed. Results A total of 26 patients were collected, including 7 males and 19 females, aged 27-67 (53.46±11.18) years. All patients had previous mitral valve surgery, including 23 mitral valve replacements and 3 mitral valve repairs. All patients received Chimney technique using the ideal artificial sized mitral valve, and 1 patient died of neurological complications in hospital. The cardiopulmonary bypass time and the aortic cross-clamping time were 231.11±77.05 min and 148.50±52.70 min, respectively. The mean diameter of the implanted mitral valve prosthesis was 29.08±0.68 mm, which was statistically different from pre-replacement valve prosthesis size of 26.69±0.77 mm (P＜0.001). The mean transvalvular pressure gradient of the prosthetic mitral valve measured on postoperative echocardiography was 14.77±5.34 mm Hg, which was statistically different from preoperative value of 20.92±9.83 mm Hg (P=0.005). Conclusion The Chimney technique is safe and effective for reoperation in patients with small mitral annuli, which can not only reduce the risk of reoperation, but also obtain larger prosthetic valve implants with good hemodynamic characteristics and clinical outcomes.

Citation： LIU Wenhao, SONG Laichun, YANG Mingyuan, WU Jingcheng, TAO Liang. Application of Chimney technique in mitral valve reoperation: A retrospective study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(5): 757-761. doi: 10.7507/1007-4848.202210036 Copy

1.	Mehaffey HJ, Hawkins RB, Schubert S, et al. Contemporary outcomes in reoperative mitral valve surgery. Heart, 2018, 104(8): 652-656.
2.	Kim HR, Kim GS, Yoo JS, et al. Minimally invasive approach for redo mitral valve replacement: No aortic cross-clamping and no cardioplegia. Korean J Thorac Cardiovasc Surg, 2015, 48(2): 126-128.
3.	Naji P, Griffin BP, Sabik JF, et al. Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement. Circulation, 2015, 132(21): 1953-1960.
4.	Magne J, Mathieu P, Dumesnil JG, et al. Impact of prosthesis-patient mismatch on survival after mitral valve replacement. Circulation, 2007, 115(11): 1417-1425.
5.	Lam BK, Chan V, Hendry P, et al. The impact of patient-prosthesis mismatch on late outcomes after mitral valve replacement. J Thorac Cardiovasc Surg, 2007, 133(6): 1464-1473.
6.	Li M, Dumesnil JG, Mathieu P, et al. Impact of valve prosthesis-patient mismatch on pulmonary arterial pressure after mitral valve replacement. J Am Coll Cardiol, 2005, 45(7): 1034-1040.
7.	Sakamoto H, Watanabe Y. Does patient-prosthesis mismatch affect long-term results after mitral valve replacement? Ann Thorac Cardiovasc Surg, 2010, 16(3): 163-167.
8.	Jamieson WR, Germann E, Ye J, et al. Effect of prosthesis-patient mismatch on long-term survival with mitral valve replacement: Assessment to 15 years. Ann Thorac Surg, 2009, 87(4): 1135-1141.
9.	吴竞成, 宋来春, 肖红艳, 等. “衬裙”技术在成人二尖瓣置换中的应用及疗效评价. 中国心血管病研究, 2022, 20(6): 527-530.
10.	Seeburger J, Borger MA, Falk V, et al. Minimally invasive mitral valve surgery after previous sternotomy: Experience in 181 patients. Ann Thorac Surg, 2009, 87(3): 709-714.
11.	Angeloni E, Melina G, Pibarot P, et al. Impact of prosthesis-patient mismatch on the regression of secondary mitral regurgitation after isolated aortic valve replacement with a bioprosthetic valve in patients with severe aortic stenosis. Circ Cardiovasc Imaging, 2012, 5(1): 36-42.
12.	Akuffu AM, Zhao H, Zheng J, et al. Prosthesis-patient mismatch after mitral valve replacement: A single-centered retrospective analysis in East China. J Cardiothorac Surg, 2018, 13(1): 100.
13.	Bolman RM. Survival after mitral valve replacement: Does the valve type and/or size make a difference? Circulation, 2007, 115(11): 1336-1338.
14.	Sung SC, Chang YH, Lee HD, et al. A novel technique of supra-annular mitral valve replacement. Ann Thorac Surg, 2008, 86(3): 1033-1035.
15.	González Rocafort Á, Aroca Á, Polo L, et al. Chimney technique for mitral valve replacement in children. Ann Thorac Surg, 2013, 96(5): 1885-1887.

1. Mehaffey HJ, Hawkins RB, Schubert S, et al. Contemporary outcomes in reoperative mitral valve surgery. Heart, 2018, 104(8): 652-656.
2. Kim HR, Kim GS, Yoo JS, et al. Minimally invasive approach for redo mitral valve replacement: No aortic cross-clamping and no cardioplegia. Korean J Thorac Cardiovasc Surg, 2015, 48(2): 126-128.
3. Naji P, Griffin BP, Sabik JF, et al. Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement. Circulation, 2015, 132(21): 1953-1960.
4. Magne J, Mathieu P, Dumesnil JG, et al. Impact of prosthesis-patient mismatch on survival after mitral valve replacement. Circulation, 2007, 115(11): 1417-1425.
5. Lam BK, Chan V, Hendry P, et al. The impact of patient-prosthesis mismatch on late outcomes after mitral valve replacement. J Thorac Cardiovasc Surg, 2007, 133(6): 1464-1473.
6. Li M, Dumesnil JG, Mathieu P, et al. Impact of valve prosthesis-patient mismatch on pulmonary arterial pressure after mitral valve replacement. J Am Coll Cardiol, 2005, 45(7): 1034-1040.
7. Sakamoto H, Watanabe Y. Does patient-prosthesis mismatch affect long-term results after mitral valve replacement? Ann Thorac Cardiovasc Surg, 2010, 16(3): 163-167.
8. Jamieson WR, Germann E, Ye J, et al. Effect of prosthesis-patient mismatch on long-term survival with mitral valve replacement: Assessment to 15 years. Ann Thorac Surg, 2009, 87(4): 1135-1141.
9. 吴竞成, 宋来春, 肖红艳, 等. “衬裙”技术在成人二尖瓣置换中的应用及疗效评价. 中国心血管病研究, 2022, 20(6): 527-530.
10. Seeburger J, Borger MA, Falk V, et al. Minimally invasive mitral valve surgery after previous sternotomy: Experience in 181 patients. Ann Thorac Surg, 2009, 87(3): 709-714.
11. Angeloni E, Melina G, Pibarot P, et al. Impact of prosthesis-patient mismatch on the regression of secondary mitral regurgitation after isolated aortic valve replacement with a bioprosthetic valve in patients with severe aortic stenosis. Circ Cardiovasc Imaging, 2012, 5(1): 36-42.
12. Akuffu AM, Zhao H, Zheng J, et al. Prosthesis-patient mismatch after mitral valve replacement: A single-centered retrospective analysis in East China. J Cardiothorac Surg, 2018, 13(1): 100.
13. Bolman RM. Survival after mitral valve replacement: Does the valve type and/or size make a difference? Circulation, 2007, 115(11): 1336-1338.
14. Sung SC, Chang YH, Lee HD, et al. A novel technique of supra-annular mitral valve replacement. Ann Thorac Surg, 2008, 86(3): 1033-1035.
15. González Rocafort Á, Aroca Á, Polo L, et al. Chimney technique for mitral valve replacement in children. Ann Thorac Surg, 2013, 96(5): 1885-1887.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of Chimney technique in mitral valve reoperation: A retrospective study in a single center

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