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Mitral valve repair thorough minithoracotomy as a first choice approach
Kazuma Okamoto, Mikihiko Kudos, Akihiro Yoshitake, Yuta Akamatsu, Hidetoshi Oka, Takayuki Kawashima, Mio Kasai, Akinori Hirano, Hiroto Kitahara, Shinji Kawaguchi, Ichiro Kashima, Ryo Aeba, Hideyuki Shimizu.
Keio University, Tokyo, Japan.

OBJECTIVE: Feasibility and current set up of mitral valve repair thoughminithoracotomy was verified and suitable repair technique formithoracotomy setting was clarified.
METHODS: 437 cases to treat mitral valve insufficiency throughminithoracotomy between 1998 and 2015 were reviewed retrospectively.Cases with mitral stenosis were excluded.
RESULTS: Mitral repair was applied in 417 cases (95.4%). In this population,age was 51±13.6 years old. Two conversions to median sternotomy occurred.The average aortic cross-clamp time, total perfusion time and operative timewere 168.5±47.2, 250.1±60.2 and 368.2±75.0 minutes, respectively. Hospitalmortality was zero. Prolapse in the anterior leaflet was found in 181 cases(43.4%). Neochordae creations were used in 313 cases (average 3.9neochordae (1 - 10)). Loop technique was used in 300 cases.
CONCLUSIONS: The surgical result of mitral valve repair thoroughminithoracotomy was excellent. Neochordae creations with loop techniquefacilitated complicated repair including anterior leaflet lesion.


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