Eighteen Neochords For The Totally Endoscopic Mitral Repair Of Bileaflet Prolapse.
Antonios Pitsis, Director.
European Interbalkan Medical Center, Thessaloniki, Greece.
BACKGROUND: The loop technique to create neochords for the repair of a prolapsed mitral valve, has become very popular in recent years, especially in the minimally invasive setting.
METHODS: In this high definition video , we describe our technique of totally endoscopic mitral repair with multiple loops (eighteen) to repair bileaflet prolapse with disjunction, in a 43 y.o. man in NYHA class 2. The length of the loops was calculated during pre-CPB TOE and found to be 22mm. The prefabricated loops were implanted in 5 different set of 4 loops, all 22 mm in length, in the corresponding papillary muscle heads, respecting the anatomy. We used 7 loops for the anterior leaflet and 11 for the posterior. Additionally a size 39 semi-flexible annuloplasty band was used to stabilise the annulus and treat the annular disjunction.
RESULTS: Post-CPB TOE showed a normal looking mitral valve without any regurgitation, without systolic anterior motion, with a nice motion of both the leaflets and a valve area of 3,9 cm2.CONCLUSIONS: Totally endoscopic mitral repair with multiple loops is a standardised and reproducible procedure with a high success rate in treating bileaflet prolapse.
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