Comparison of early postoperative results between conventional and transapical mitral valve repair

Aleksejus Zorinas; Artūras Lipnevicius; Viktorija Bleizgytė; Vilius Janušauskas; Daina Liekienė; Mindaugas Budra; Robertas Samalavičius; Agnė Drąsutienė; Diana Zakarkaitė; Audrius Aidietis; Kęstutis Ručinskas

doi:10.5114/aic.2019.90218

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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Original paper

Comparison of early postoperative results between conventional and transapical mitral valve repair

Aleksejus Zorinas

¹

,

Artūras Lipnevicius

¹

,

Viktorija Bleizgytė

¹

,

Vilius Janušauskas

¹

,

Daina Liekienė

¹

,

Mindaugas Budra

¹

,

Robertas Stasys Samalavičius

²

,

Agnė Drąsutienė

¹

,

Diana Zakarkaitė

¹

,

Audrius Aidietis

¹

,

Kęstutis Ručinskas

¹

Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania
Centre of Anaesthesia, Intensive Care, and Pain Management, Department of Intensive Care, Vilnius University, Vilnius, Lithuania

Adv Interv Cardiol 2019; 15, 4 (58): 439–445

DOI: https://doi.org/10.5114/aic.2019.90218

Online publish date: 2019/12/08

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AMA

Zorinas A, Lipnevicius A, Bleizgytė V, et al. Comparison of early postoperative results between conventional and transapical mitral valve repair. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2019;15(4):439-445. doi:10.5114/aic.2019.90218.

APA

Zorinas, A., Lipnevicius, A., Bleizgytė, V., Janušauskas, V., Liekienė, D.,  & Budra, M. et al. (2019). Comparison of early postoperative results between conventional and transapical mitral valve repair. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 15(4), 439-445. https://doi.org/10.5114/aic.2019.90218

Chicago

Zorinas, Aleksejus, Artūras Lipnevicius, Viktorija Bleizgytė, Vilius Janušauskas, Daina Liekienė, Mindaugas Budra,  and Robertas S Samalavičius et al. 2019. "Comparison of early postoperative results between conventional and transapical mitral valve repair". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 15 (4): 439-445. doi:10.5114/aic.2019.90218.

Harvard

Zorinas, A., Lipnevicius, A., Bleizgytė, V., Janušauskas, V., Liekienė, D., Budra, M., Samalavičius, R., Drąsutienė, A., Zakarkaitė, D., Aidietis, A.,  and Ručinskas, K. (2019). Comparison of early postoperative results between conventional and transapical mitral valve repair. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 15(4), pp.439-445. https://doi.org/10.5114/aic.2019.90218

MLA

Zorinas, Aleksejus et al. "Comparison of early postoperative results between conventional and transapical mitral valve repair." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 15, no. 4, 2019, pp. 439-445. doi:10.5114/aic.2019.90218.

Vancouver

Zorinas A, Lipnevicius A, Bleizgytė V, Janušauskas V, Liekienė D, Budra M et al. Comparison of early postoperative results between conventional and transapical mitral valve repair. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2019;15(4):439-445. doi:10.5114/aic.2019.90218.

Introduction
Conventional mitral valve repair (CMVR) is well-established, safe and effective treatment for degenerative mitral regurgitation (MR). Transapical off-pump implantation of artificial chordae (TA) has been introduced into practice and gained interest among surgeons. However, there are no publications comparing the results between TA and CMVR.

Aim
To compare early postoperative outcomes of CMVR with TA in patients with degenerative MR.

Material and methods
This was a retrospective cohort study. A total of 169 patients who underwent mitral valve repair between 2011 and 2018 were included in this analysis. Patients were divided into two groups: the TA group, n = 78 and CMVR group, n = 91. The groups were compared for early postoperative outcomes.

Results
Patients in the TA group were younger, 54.2 ±11.1 vs. 59.5 ±12.8 years (p = 0.005). Patients in the CMVR group had more complicated postoperative course with higher incidence of blood transfusion (42.9% vs. 7.8%, p = 0.001), atrial fibrillation (25.3% vs. 11.7%, p = 0.031), renal insufficiency (15.4% vs. 2.6%, p = 0.007) and stroke (2.1% vs. 0%). In the early postoperative period, one patient died in the TA group, and there were no deaths in the CMVR group (p = 0.277). Residual moderate to severe mitral regurgitation was present in nine (11.5%) TA patients, while none of the patients in the CMVR group had moderate or a higher degree of residual regurgitation (p = 0.001).

Conclusions
Off-pump transapical MV repair is a feasible and safe procedure with low postoperative morbidity rates. Higher rates of mitral regurgitation reoccurrence would require a careful and thorough selection of the patients suitable for the TA approach.

keywords:

Comparison of early postoperative results between conventional and transapical mitral valve repair

Aleksejus Zorinas 1 , Artūras Lipnevicius 1 , Viktorija Bleizgytė 1 , Vilius Janušauskas 1 , Daina Liekienė 1 , Mindaugas Budra 1 , Robertas Stasys Samalavičius 2 , Agnė Drąsutienė 1 , Diana Zakarkaitė 1 , Audrius Aidietis 1 , Kęstutis Ručinskas 1

minimally invasive surgery, mitral regurgitation, transapical mitral valve repair