Mitral Repair by Minimally Invasive Approach

Mitral valve repair is shown to have better survival, better preservation of ventricular function, and decreased thromboembolic complications compared to mitral valve replacement for mitral regurgitation (1-2). The Cardiovascular Institute of Buenos Aires in Argentina is a center with extensive experience in mitral repair, with a 98% success rate in posterior valve.

The authors present a mitral valve repair performed for a 69-year-old woman. Her cardiovascular history includes smoking, dyslipidemia, and asymptomatic severe mitral insufficiency due to prolapsed P2-P3 that was associated with pulmonary hypertension at rest. The transthoracic echocardiogram showed severe mitral regurgitation due to prolapse of the posterior leaflet, predominance of segment P2-P3, and an image compatible with second-order chordal rupture. We proceeded with mitral repair through a minimally invasive approach, performing a triangular resection and placing a neochord. The patient did well, without complications. No transfusion or inotropic drugs were required. She stayed in the intensive care unit for 24 hours and was discharged on the fourth day after surgery.

References

1. Lawrie GM. Mitral valve repair vs replacement. Current recommendations and long-term results. Cardiol Clin. 1998;16(3):437-448.
2. McClure RS, Cohn LH, Wiegerinck E, et al. Early and late outcomes in minimally invasive mitral valve repair: an eleven-year experience in 707 patients. J Thorac Cardiovasc Surg. 2009;137(1):70-75.