Totally endoscopic mitral valve repair with Loop technique

Abstract

Objective To investigate the clinical effect of totally thoracoscopic Loop technique in the treatment of mitral valve prolapse. Methods From October 2014 to October 2018, 27 patients with mitral valve prolapse in Wuhan Asia Heart Hospital and PKU care Zhuzhou Kind Cardiovascular Disease Hospital were treated with totally thoracoscopic Loop technique (n=27). According to the preoperative computed tomography (CT) measurements of the patients, the artificial chordae tendineae were prefabricated, and the artificial chordae tendineae were placed under the total thoracoscopy and the pericardial annulus was used to shrink the mitral valve. The number of chordae tendineae used, the length of chordae tendineae, aorta occlusion time, transit time and operation time were recorded. The left ventricle diameter, left atrium diameter and cardiac blood reflux before and after treatment were observed. In addition, the overall incidence of complications from thromboembolism and infective endocarditis was monitored. Results After treatment, all patients had no operative deaths, no reoperation, and no important organ complications. After total thoracoscopic Loop technique, the indexes of left ventricular diameter (5.01±0.21) cm and left atrial diameter (3.91±0.21) cm were significantly lower than those before surgery LV (6.17±0.16) cm, LA (5.33±0.18) cm, with significant statistical significance (t=10.100, P<0.01). Transesophageal echocardiography (TEE) examination was performed immediately after surgery. All the cases had mild reflux or no reflux. No postoperative thromboembolism and complications of infective endocarditis occurred, and the overall incidence was significantly lower than that of 7 cases (25.93%) before surgery (χ2=8.043, P<0.05). Conclusion Thoracoscopy can better expose the mitral valve and papillary muscle, and totally thoracoscopy Loop technique is more effective in the treatment of mitral valve prolapse. Key words: Thoracoscopy; Loop technique; Mitral valve prolapse