Abstract:
OBJECTIVES:Previous series of minimally invasive mitral valve repairs showed excellent results at up to 10 years of follow-up. The goal of this study was to assess the long-term durability beyond 10 years of the edge-to-edge repair for myxomatous degeneration performed through a minimally invasive approach. METHODS:Ninety-seven consecutive patients (mean age 35 ± 9 years; left ventricular ejection fraction 63 ± 6%) with severe myxomatous mitral regurgitation (MR) underwent mitral valve repair through a right minithoracotomy between 1999 and 2006. MR was due to lesions involving the posterior leaflet (7.2% of patients), anterior leaflet (12.4%) and both leaflets (80.4%). RESULTS:No hospital deaths occurred. At hospital discharge all patients had no or trivial MR. Follow-up was 100% complete (median 15.5 years; interquartile range 13.6-17.0, max 19.3 years). The 16-year overall survival rate was 95.9 ± 2.02% [95% confidence interval (CI) 89.39-98.43]. At 16 years, the cumulative incidence function of cardiac death, with non-cardiac death as a competing risk, was 3.1 ± 1.75 (95% CI 0.83-8.02). Only 3 patients (4.1%) had redo operations for recurrent severe MR. At 16 years, the cumulative incidence functions of reoperation for and recurrence of MR ≥3+, with death as a competing risk, were 3.1 ± 1.76% (95% CI 0.83-8.02) and 5.6 ± 2.47% (95% CI 2.06-11.83), respectively. No predictors of recurrence of MR ≥3+ were identified. At the last follow-up, moderate MR (2+/4+) was detected in 17 patients (17.5%); most of the patients were in New York Heart Association functional class I-II (97%) and in sinus rhythm (90%). CONCLUSIONS:Minimally invasive mitral valve edge-to-edge repair through a right minithoracotomy for myxomatous degeneration appears to be an effective and durable approach even in the long-term follow-up (up to 19 years).
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Belluschi I,Lapenna E,Blasio A,Del Forno B,Giacomini A,Ruggeri S,Schiavi D,Castiglioni A,Alfieri O,De Bonis Mdoi
10.1093/icvts/ivaa048subject
Has Abstractpub_date
2020-07-01 00:00:00pages
28-34issue
1eissn
1569-9293issn
1569-9285pii
5813302journal_volume
31pub_type
杂志文章abstract:OBJECTIVES:The systolic anterior motion (SAM) of mitral valves occurs at a certain rate despite the introduction of several preventive procedures. The purpose of this study was to investigate its mechanism by analysing the change in mitral valve morphology associated with operative procedures. METHODS:Components of mi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs023
更新日期:2012-08-01 00:00:00
abstract::We report a successful surgical management of postinfarction ventricular septal perforation by infarction-exclusion technique with the on-pump beating heart approach and concomitant coronary artery bypass grafting. The identification of the suture line by direct inspection and finger palpation could be more accurate i...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.188359
更新日期:2008-12-01 00:00:00
abstract::Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat depression. We report a case of serotonin syndrome following cardiac surgery. This syndrome is rare in the cardiac literature. The clinical features, diagnosis and management of this unusual syndrome are described. In patients with polypharmacy, ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.173104
更新日期:2008-08-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, what is the optimal dose of aspirin post cardiac surgery that should be given to prevent graft occlusion and prolong survival. Altogether, 114 papers were found from Medline and 59 papers were found fro...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00202-0
更新日期:2003-12-01 00:00:00
abstract::Six patients with acute Type A aortic dissection were medically treated due to advanced age, patient refusal and comorbidity despite surgical indication. Computed tomography after onset revealed a thrombosed false lumen in 3 patients and a patent false lumen with flap in 3 patients. All patients were stable during adm...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx404
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVES:The use of staplers for thoracic surgery has been widely accepted and regarded as a safe procedure. However, adverse events (AEs) of stapling are occasionally experienced. The aim of this retrospective study was to analyse the AEs of stapling in pulmonary vascular surgery. METHODS:A retrospective multi-inst...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1093/icvts/ivt130
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:The ability to accurately characterize a pulmonary air leak is an essential skill in chest medicine and surgery. The objective was to evaluate interobserver variability in air leak assessments using analogue and digital pleural drainage systems. METHODS:Air leak severity in lung resection patients with a pu...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv128
更新日期:2015-10-01 00:00:00
abstract::Early repair of postinfarction ventricular septal rupture is usually associated with significant mortality and morbidity. Assessing conditions to moderately delay the surgical intervention and reduce cardioplegic arrest may be an interesting approach to improve hospital results. Results of five non-selected patients i...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.100255
更新日期:2005-06-01 00:00:00
abstract::In patients undergoing total arch replacement with protruding or mobile atheroma in the proximal aorta, we isolate cerebral circulation from systemic one by starting selective cerebral perfusion (SCP) before systemic arterial perfusion to prevent aortogenic embolic stroke. We disclose the safety of this isolation tech...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.164137
更新日期:2008-02-01 00:00:00
abstract::Cardiac myxomas are the commonest benign tumour of the heart. We are describing a rare presentation of a myxoma in a patient with renal cell carcinoma (RCC). Since there was no single reported case of myxoma with RCC, a presumptive diagnosis of RCC with right atrial extension of tumour thrombus was made. Both the tumo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.227504
更新日期:2010-05-01 00:00:00
abstract::From April 1996 to July 1999, 241 consecutive patients underwent complete arterial revascularization with composite T-graft, including right coronary artery grafting with free right internal thoracic artery (ITA) (ITA group). They were compared with 127 bilateral ITA patients in whom saphenous vein grafts (SVG) was us...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/s1569-9293(02)00062-2
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVES:Cervical mediastinoscopy may become essential in patients with pathological lymph nodes at mediastinum after laryngectomy. However, having had a previous tracheostomy has been reported to be a contraindication for cervical mediastinoscopy. METHODS:Between January 2010 and December 2017, cervical mediastinos...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz178
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:Intestinal ischaemia is an uncommon (<1%) but serious complication of cardiac surgery with a mortality rate exceeding 50%. Diagnosis of this potentially lethal condition can be difficult and requires a high index of suspicion. The purpose of this study was to analyse the outcomes and prognostic factors in pa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs181
更新日期:2012-08-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'Does the use of bilateral mammary artery grafts compared with the use of a single mammary artery graft offer a long-term survival benefit in patients undergoing coronary artery bypass surgery?' Altoget...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivt423
更新日期:2014-01-01 00:00:00
abstract::Transatrial cannulation of the left ventricle was introduced as a safe and easy cannulation method for antegrade arterial return in type A aortic dissection. However, because of the paucity of clinical reports, little is known about the complications or shortcomings of this technique. Herein, we report a case of pulmo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz190
更新日期:2019-12-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether methylene blue (MB) is of benefit in treating adult patients who develop catecholamine-resistant vasoplegic syndrome (VPS) during cardiac surgery. Altogether 47 papers were found in Medline and 1...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.134726
更新日期:2006-12-01 00:00:00
abstract::American Heart Association recommendations have changed preoperative management of patients with antiplatelet therapy (APT). We assessed safety and outcomes of surgery in patients who were receiving APT. A prospective study of patients operated on while receiving APT was matched with those with no APT (ratio 1:4), usi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr005
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:In the belief that stress is the main determinant of leaflet quality deterioration, we sought to evaluate the effect of annular and/or sino-tubular junction dilatation on leaflet stress. A finite element computer-assisted stress analysis was used to model four different anatomic conditions and analyse the co...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt116
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:Deep sternal wound infection (DSWI) after cardiovascular surgery via median sternotomy remains a severe complication associated with a drastic decrease in the quality of life. We assessed the risk factors for in-hospital death caused by DSWI and the available treatments for DSWI. METHODS:Between January 199...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw141
更新日期:2016-09-01 00:00:00
abstract::Extracorporeal membrane oxygenation has been recently indicated as an ex utero intrapartum treatment procedure for placental support in patients with a large thoracic mass. In our case, a foetus with truncus arteriosus communis and hydrops with ventricular failure due to severe truncal valve stenosis was delivered und...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx303
更新日期:2018-02-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represent...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivt184
更新日期:2013-08-01 00:00:00
abstract::Empyema after lung resection is a challenging condition to manage and is associated with a high mortality. Intrathoracic application of a vacuum-assisted closure (VAC) device is recently introduced as an adjunct in the management of this condition. A best evidence topic was constructed to address whether this approach...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.267286
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:Detailed anatomical information is essential for planning of surgical therapy in patients with congenital heart disease. We wanted to determine whether cinematic rendering, the novel 3-dimensional visualization technique, could help paediatric cardiac surgeons achieve better preoperative visualization of the...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy348
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:Surgical management of acute DeBakey Type I aortic dissection without intimal tear in the aortic arch is controversial. This study compared short- and long-term outcomes of total arch replacement (TAR) versus limited ascending aorta/hemiarch replacement (no-TAR) in a consecutive series of patients. METHODS:...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx229
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:The purposes of this study were to identify possible compression points along the transit route of the subclavian artery and to provide a detailed anatomical analysis of areas that are involved in the surgical management of the thoracic outlet syndrome (TOS). The results of the current study are based on mea...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy129
更新日期:2018-10-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the of vegetations in endocarditis is an indication for surgery. Altogether, 102 papers were found using the reported search; 16 papers were identified that provided the best evidence to answer t...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs365
更新日期:2012-12-01 00:00:00
abstract::Abdominal compartment syndrome is a possible complication after aneurysm repair and has a high mortality rate. Although there has been an increment in patient survival rates after aneurysm repair, there has also been an increase in this entity. However, there are few data about the incidence and management of this com...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs030
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:Many patients referred for coronary artery bypass surgery (CABG) today have diffusely diseased coronary vessels, and some of them may require coronary endarterectomy to provide adequate revascularization. Most reports of coronary endarterectomy describe an on-pump procedure. As off-pump coronary artery bypas...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs482
更新日期:2013-03-01 00:00:00
abstract::The patient was a 34-year-old woman who developed multiple post-myocarditis ventricular aneurysms with ventricular tachyarrhythmia. After implantation of an intracardiac defibrillator, she experienced multiple episodes of counter-shock. An electrophysiological study demonstrated an early excitation circuit entering th...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz258
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:The superiority of supra-annular aortic prostheses over intra-annular equivalents in long-term haemodynamics and clinical outcomes remains controversial. This study compared outcomes among patients receiving supra-annular or intra-annular prostheses during aortic valve replacement. METHODS:We enrolled 587 c...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy190
更新日期:2019-01-01 00:00:00