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

J Cardiothorac Surg. 2024 Apr 16;19(1):233. doi: 10.1186/s13019-024-02705-y.

Abstract

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.

Keywords: Barlow’s disease; Mitral regurgitation; Mitral valve repair; Totally endoscopic.

MeSH terms

  • Cardiac Surgical Procedures* / methods
  • Female
  • Humans
  • Male
  • Mitral Valve / surgery
  • Mitral Valve Annuloplasty* / methods
  • Mitral Valve Insufficiency* / surgery
  • Mitral Valve Prolapse* / surgery
  • Treatment Outcome