Micro vascular clip for mitral valve repair
Nagano red cross hospital, Nagano, Japan.
OBJECTIVE: This study was done to evaluate potential benefits of Micro vascular clip (BEAR medic, Ibaraki, Japan) in minimally invasive mitral surgery.
METHODS: Micro vascular clip is a small artery and vein clamp, which is globally used for hemostasis in plastic surgery. Its length is 14.5 mm and weight is 0.051 g. From February to November in 2015, the Micro vascular clip was used during mitral valve repair in 6 patients (female 4, male 2). The age was 67.7 ± 16 years old and ranged from 39 to 81 years. Ejection fraction was 67.2% ± 12% (35% to 62%). ALL patients had severe mitral regurgitation due to leaflet prolapse (anterior leaflet 2, posterior leaflet 4). All operations were done by mini right thoracotomy and loop in loop technic with CV-4 (GORE medical, AZ, USA). We utilized the Micro vascular clip to hold artificial chordae height for regurgitation test with normal serine injection into the left ventricle and to keep a knot position during tying the CV-4. Physio ring II(Carpentier Edwards, CA, USA)were applied for annuloplasty in all patients.
RESULTS: No hospital death occurred. No major complication was observed although three patients suffered from paroxysmal atrial fibrillation. The number of artificial chordae was 2.0 ± 0.9 couples and the mean ring size was 29.3 ± 1.6 mm. Postoperative echocardiography showed no regurgitation in three, mild in two and moderate in one patient.
CONCLUSIONS: This initial study suggested that the Micro vascular clip was useful for adjustment of the artificial chordae height in MV repair. The clip weighs only 0.051 g and applies no impediment force on the artificial chordae during the leak test.
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