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.	?來永強."緣對緣"技術在瓣膜成形術中的應用. 中華胸心血管外科雜志, 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.	孫海寧, 王巍, 宋云虎, 等. 二尖瓣成形術治療二尖瓣前葉脫垂的療效分析. 中國胸心血管外科臨床雜志, 2010, 17(4):283-286.
4.	鄧學峰, 高長青. 二尖瓣成形術治療二尖瓣關閉不全. 中國胸心血管外科臨床雜志, 2008, 15(2):134-137.
5.	孫廣龍, 曹向戎, 張健群. 線圈式人工腱索二尖瓣成形術治療二尖瓣前葉脫垂的臨床分析. 中國胸心血管外科臨床雜志, 2013, 20(4):420-424.
6.	陳偉, 張健群, 甘輝立, 等. 腱索折疊與腱索轉移矯治二尖瓣前瓣脫垂的比較分析. 中國胸心血管外科臨床雜志, 2010, 17(1):26-31.
7.	修宗誼, 谷天祥, 喻磊, 等. 二尖瓣成形術治療二尖瓣反流89 例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(6):676-677.
8.	侯予龍, 沈振亞."雙孔"二尖瓣成形術治療二尖瓣關閉不全 21 例臨床分析. 蘇州大學學報:醫學版, 2009, 29(1):165-166.
9.	劉菁, 盧聰, 黃煥雷, 等. 雙孔成形術治療二尖瓣關閉不全. 嶺南心血管病雜志, 2008, 14(1):37-38.
10.	孫凌波, 孟旭, 張純, 等."緣對緣"二尖瓣成形術治療二尖瓣前葉脫垂的早中期隨訪. 中華胸心血管外科雜志, 2008, 24(6):373-375.
11.	馬松峰, 喬峻, 木拉提, 等. 雙孔二尖瓣成形術后的中長期隨訪. 心臟雜志, 2008, 20(1):120.
12.	薛清, 韓林, 張冠鑫, 等. 緣對緣瓣葉縫合技術治療退行性二尖瓣關閉不全的臨床分析. 中華外科雜志, 2012, 50(1):32-34.
13.	蔣南青, 張曉膺, 錢永祥, 等. 應用"雙孔"技術與 Cosgrove 軟質環行二尖瓣成形術. 中國胸心血管外科臨床雜志, 2004, 11(4):272.
14.	張純, 李治安, 王炯. 超聲心動圖對雙孔成形術治療二尖瓣前葉脫垂的評價. 中國超聲醫學雜志, 2005, 21(10):751-753.
15.	李進華, 來永強, 王炯等."緣對緣"二尖瓣成形術對左心室舒張功能的影響. 中國胸心血管外科臨床雜志, 2009, 16(5):344-347.
16.	潘文明, 舒先紅, 洪濤, 等. 超聲心動圖評價二尖瓣前葉脫垂緣對緣成形術效果. 中華超聲影像學雜志, 2009, 18(2):125-127.
17.	金亮, 侯健, 鄭勇, 等. 冠狀動脈旁路移植同期行二尖瓣成形術治療缺血性二尖瓣關閉不全. 中國胸心血管外科臨床雜志, 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, 張紅. 雙孔成形術治療二尖瓣前葉脫垂. 中華胸心血管外科雜志, 2003, 19(2):74-76.
21.	李清寶, 董明亮, 李德才, 等. 改良edge-to-edge 二尖瓣成形術治療成人二尖瓣前葉脫垂的作用. 山東大學學報:醫學版, 2012, 50(10):90-92.

1. ?來永強."緣對緣"技術在瓣膜成形術中的應用. 中華胸心血管外科雜志, 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. 孫海寧, 王巍, 宋云虎, 等. 二尖瓣成形術治療二尖瓣前葉脫垂的療效分析. 中國胸心血管外科臨床雜志, 2010, 17(4):283-286.
4. 鄧學峰, 高長青. 二尖瓣成形術治療二尖瓣關閉不全. 中國胸心血管外科臨床雜志, 2008, 15(2):134-137.
5. 孫廣龍, 曹向戎, 張健群. 線圈式人工腱索二尖瓣成形術治療二尖瓣前葉脫垂的臨床分析. 中國胸心血管外科臨床雜志, 2013, 20(4):420-424.
6. 陳偉, 張健群, 甘輝立, 等. 腱索折疊與腱索轉移矯治二尖瓣前瓣脫垂的比較分析. 中國胸心血管外科臨床雜志, 2010, 17(1):26-31.
7. 修宗誼, 谷天祥, 喻磊, 等. 二尖瓣成形術治療二尖瓣反流89 例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(6):676-677.
8. 侯予龍, 沈振亞."雙孔"二尖瓣成形術治療二尖瓣關閉不全 21 例臨床分析. 蘇州大學學報:醫學版, 2009, 29(1):165-166.
9. 劉菁, 盧聰, 黃煥雷, 等. 雙孔成形術治療二尖瓣關閉不全. 嶺南心血管病雜志, 2008, 14(1):37-38.
10. 孫凌波, 孟旭, 張純, 等."緣對緣"二尖瓣成形術治療二尖瓣前葉脫垂的早中期隨訪. 中華胸心血管外科雜志, 2008, 24(6):373-375.
11. 馬松峰, 喬峻, 木拉提, 等. 雙孔二尖瓣成形術后的中長期隨訪. 心臟雜志, 2008, 20(1):120.
12. 薛清, 韓林, 張冠鑫, 等. 緣對緣瓣葉縫合技術治療退行性二尖瓣關閉不全的臨床分析. 中華外科雜志, 2012, 50(1):32-34.
13. 蔣南青, 張曉膺, 錢永祥, 等. 應用"雙孔"技術與 Cosgrove 軟質環行二尖瓣成形術. 中國胸心血管外科臨床雜志, 2004, 11(4):272.
14. 張純, 李治安, 王炯. 超聲心動圖對雙孔成形術治療二尖瓣前葉脫垂的評價. 中國超聲醫學雜志, 2005, 21(10):751-753.
15. 李進華, 來永強, 王炯等."緣對緣"二尖瓣成形術對左心室舒張功能的影響. 中國胸心血管外科臨床雜志, 2009, 16(5):344-347.
16. 潘文明, 舒先紅, 洪濤, 等. 超聲心動圖評價二尖瓣前葉脫垂緣對緣成形術效果. 中華超聲影像學雜志, 2009, 18(2):125-127.
17. 金亮, 侯健, 鄭勇, 等. 冠狀動脈旁路移植同期行二尖瓣成形術治療缺血性二尖瓣關閉不全. 中國胸心血管外科臨床雜志, 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, 張紅. 雙孔成形術治療二尖瓣前葉脫垂. 中華胸心血管外科雜志, 2003, 19(2):74-76.
21. 李清寶, 董明亮, 李德才, 等. 改良edge-to-edge 二尖瓣成形術治療成人二尖瓣前葉脫垂的作用. 山東大學學報:醫學版, 2012, 50(10):90-92.

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