Carpentier’s Reconstructive Valve Surgery

Mungara, Charan; Lozonschi, Lucian

doi:10.1016/j.jss.2011.05.013

Cited by 3 publications

(4 citation statements)

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“…Although the implantation of artificial chordae can pull the mitral leaflet that prolapse into the left atrium back into the left ventricle, the billowing change leaflet is still exist. Mungara, C et al reported that due to the large size of the mitral orifice in Barlow’s disease, although it was not the optimal procedure for impeding normal function of commissure, correction of limited internal commissure prolapse with two or three uniform sutures across the commissure was a useful supplement to the treatment of complex Barlow’s disease with secondary lesions [ 17 ]. Given the specificity of the totally endoscopic procedure, we often used relatively simple techniques, and the posterior commissure was usually advanced medially by two or three magic stitches.…”

Section: Discussionmentioning

confidence: 99%

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Mid-term clinical outcomes of totally endoscopic repair for mitral regurgitation in Barlow’s disease

Zhang,

Cui,

Shen

et al. 2024

J Cardiothorac Surg

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Objective This study aimed to confirm the safety and feasibility of totally endoscopic repair for mitral regurgitation (MR) in Barlow’s disease. Methods From June 2018 to December 2022, 21 consecutive Barlow’s disease patients (aged 33 ± 12 years; 57.1% male) underwent totally endoscopic mitral valve (MV) repair with leaflets folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its mid-term clinical outcomes. Results There was no operative death or complications. The mean cardiopulmonary bypass (CPB) time was 190 ± 41 (128–267) min, and the aortic cross-clamp time was 145 ± 32 (66–200) min. The average number of artificial chordae implantation was 2.9 ± 0.7 (1–4) pairs. The mean MV coaptation length was 1.4 ± 0.3 (0.8–1.8) cm, and the median transvalvular gradient was 1 [interquartile range (IQR), 1–2] mmHg. During a median follow-up time of 24 (IQR, 10–38) months, all patients showed persistent effective valve function with no significant MR or systolic anterior motion. Conclusions Totally endoscopic repair was a safe, effective, and reproducible procedure with satisfied mid-term clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.

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Section: Discussionmentioning

confidence: 99%

“…Ring annuloplasty is considered as an important auxiliary means for valve repair and an important guarantee for long-term good results of MV repair [ 17 ]. In 1987, Levine et al first described the three-dimensional saddle shape of the mitral annulus [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Mid-term clinical outcomes of totally endoscopic repair for mitral regurgitation in Barlow’s disease

Zhang,

Cui,

Shen

et al. 2024

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…Although the implantation of arti cial chordae can pull the mitral lea et that prolapse into the left atrium back into the left ventricle, the billowing change lea et is still exist. Mungara, C et al reported that due to the large size of the mitral ori ce in Barlow's disease, although it was not the optimal procedure for impeding normal function of commissure, correction of limited internal commissure prolapse with two or three uniform sutures across the commissure was a useful supplement to the treatment of complex Barlow's disease with secondary lesions [17].…”

Section: Correction Of Internal Commissurementioning

confidence: 99%

“…Ring annuloplasty is considered as an important auxiliary means for valve repair and an important guarantee for long-term good results of MV repair [17]. In 1987, Levine et al rst described the three-dimensional saddle shape of the mitral annulus [18].…”

Section: Ring Annuloplasty and Selectionmentioning

confidence: 99%

Mid-term Clinical Outcomes of Totally Thoracoscopic Repair for Mitral Regurgitation in Barlow’s Disease

Zhang,

Cui,

Shen

et al. 2023

Preprint

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Objective This study aimed to confirm the safety and feasibility of totally thoracoscopic repair for mitral regurgitation (MR) in Barlow’s disease. Methods From June 2018 to December 2022, 21 consecutive Barlow's disease patients (aged 33 ± 12 years; 57.1% male) underwent totally thoracoscopic mitral valve (MV) repair with leaflets folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its mid-term clinical outcomes. Results There was no operative death or complications. The mean cardiopulmonary bypass (CPB) time was 190 ± 41 (128–267) min, and the aortic cross-clamp time was 145 ± 32 (66–200) min. The average number of artificial chordae implantation was 2.9 ± 0.7 (1–4) pairs. During a mean follow-up time of 25.6 ± 15.2 (1–52) months, all patients showed persistent effective valve function with a mean transvalvular gradient of 1.995 ± 1.543 (1.0–6.0) mmHg and no significant MR (10 cases of mild MR) or systolic anterior motion (SAM). Conclusions Totally thoracoscopic repair was a safe, effective, and reproducible procedure with satisfied mid-term clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.

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Short-Term Results on Leaflet Mobility in Patients Undergoing Rheumatic Mitral Valve Repair With an Efficient 4-Step Commissuroplasty Technique

Tian

Han

et al. 2022

Texas Heart Institute Journal

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Background Mitral valve stenosis (MS) is the primary pathologic feature of rheumatic mitral valve disease, and the complex repair affects its clinical outcome. This study aimed to examine the efficacy of the 4-step commisuroplasty “SCORe” procedure by assessing changes in the mobility of mitral valve leaflets and its clinical effects. Methods From September 1, 2018, to January 13, 2019, patients with MS who underwent mitral valve repair with the SCORe procedure in the study center were analyzed in this prospective study. Mitral valve structure was assessed by transthoracic echocardiography pre- and postoperatively as well as during follow-up. Results In total, 60 consecutive patients were examined. In 56 patients (93.3%), mitral valve orifice area (MVOA) was less than 1.5 cm2, and mean (SD) MVOA for the whole cohort was 1.20 (0.34) cm2. The mobility of the anterior leaflet was improved (P < .001) during the cardiac cycle postsurgery, but that of the posterior leaflet was not (P = .591). The mean (SD) coaptation length was increased significantly from 6.69 (1.32) mm to 7.92 (1.24) mm (P < .001) postoperatively. Mean (SD) MVOAs increased to 2.24 (0.38) cm2 postoperatively (P < .001). During the 1-year follow-up, there were no deaths or reoperations. Follow-up echocardiography revealed minor or mild regurgitation in 98.3% of patients. Conclusion These findings demonstrated that the SCORe procedure can effectively improve the mobility of mitral leaflets and enlarge the valve orifice area in patients with rheumatic MS in China, with minimal complications and promising results.

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Carpentier’s Reconstructive Valve Surgery

Cited by 3 publications

References 0 publications

Mid-term clinical outcomes of totally endoscopic repair for mitral regurgitation in Barlow’s disease

Mid-term clinical outcomes of totally endoscopic repair for mitral regurgitation in Barlow’s disease

Mid-term Clinical Outcomes of Totally Thoracoscopic Repair for Mitral Regurgitation in Barlow’s Disease

Short-Term Results on Leaflet Mobility in Patients Undergoing Rheumatic Mitral Valve Repair With an Efficient 4-Step Commissuroplasty Technique

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