Follow-Up of the Novel Free Margin Running Suture Technique for Mitral Valve Repair

Abstract

The free margin running suture (FMRS) is a novel technique for nonresection correction of degenerative mitral regurgitation. It was employed in 37 minimally invasive mitral repair cases. We performed a retrospective collection of in-hospital data and a clinical/echocardiographic follow-up. All patients were discharged with none or mild mitral regurgitation, except one who had mild-to-moderate (2+) regurgitation. At follow-up (average: 2.1 years), all patients were alive; there were no instances of recurrent regurgitation, one case of 2+ regurgitation, and no valve-related complications. Average mitral valve area, mean gradient, and coaptation length were 2.9 cm ±0.1, 3.5 mm Hg ±0.9, and 1.1 cm ±0.2.

Versatility of endoaortic balloon occlusion device for less invasive management of complex and reoperative cardiac cases

“…Myocardial protection was therefore achieved through the delivery of Custodiol cardioplegia (including within the patent GSV graft) and through moderate systemic hypothermia (patent and unclamped LITA graft). Cardioplegia flow within the GSV graft was confirmed by TEE control (Figure B) Mitral valve repair was performed through nonresection posterior leaflet remodeling (P1 and P3 prolapse) and implantation of a 32‐mm complete ring . After removal or aortic clamp, the patient was weaned from CPB (aortic clamp and CPB times: 105 and 135 minutes); the postoperative course was globally uneventful, without low cardiac output syndrome, and marked by the need for a permanent pacemaker.…”

Robotic Mitral Valve Repair Through Nonresectional Posterior Leaflet Remodeling

“…7 The initial follow-up in the first 37 FMRS recipients indicated no mitral regurgitation recurrence at an average 2.1 ± 1.4 years after surgery, and only 1 case of residual mild-to-moderate (2+/4+) regurgitation. 3 A larger follow-up in a cohort of 103 consecutive recipients at 2 centers confirmed only 1 case (0.9%) of 2+/4+ residual mitral regurgitation at an average 1.9 ± 1.3 years follow-up. 4 In the same series, no patient required a second CPB run to correct systolic anterior motion of the anterior mitral leaflet, possibly due to the frequent implantation of large-sized rings, despite all of them were complete rings.…”

“…1 The nonresectional posterior leaflet remodeling technique or free margin running suture (FMRS) has been recently proposed; 2 its early and mid-term follow-up have been published recently. 3,4 Herein, we depict the first performance of such technique in robotic-assisted mitral valve repair. Its general features and its characteristics potentially capable to facilitate and standardize robotic-assisted mitral repair in complex mitral anatomy are discussed.…”

Comparative myocardial protection of endoaortic balloon versus external clamp in minimally invasive mitral valve surgery

“…Our surgical MIMVS technique has been previously described 19–21 . Briefly, a 4–6 cm right anterolateral mini-thoracotomy at the fourth or third intercostal space (working port) was performed.…”

“…Our surgical MIMVS technique has been previously described. [19][20][21] Briefly, a 4-6 cm right anterolateral mini-thoracotomy at the fourth or third intercostal space (working port) was performed. A 308 camera or an Endocamaleon camera (Karl Storz Inc., Tuttlingen, Germany), introduced through a second port, was adopted for videoassistance.…”