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Safety And Efficacy Of Rechord System In Patients Undergoing Minimally Invasive Mitral Valve Repair
Hiroyuki Nishi, Mutsunori Kitahara, Yukie Shirasaki, Masao Yoshitatsu;
National Hospital Organization, Osaka National Hospital, Osaka, Japan
BACKGROUND: In patients who require mitral valve repair, it is difficult to determine the appropriate length of artificial chordae. The Memo 3D/4D Rechord, a complete prosthetic ring developed for use as a temporary chordal guide system, is comprised of yellow loops that function as a reference for automatically determining the height of neo-chordae. We sought to evaluate safety and efficacy of this system as part of a minimally invasive right thoracotomy approach.
METHODS: Between June 2016 and October 2023, 53 patients (33 males, mean 63±10 years old) underwent a minimally invasive mitral valve repair with Memo 3D/4D Rechord system, and were included in this study. We assessed preoperative status, operative procedure as well as short outcome, and long-term results.
RESULTS: Nine patients had anterior leaflet prolapse, while 35 had posterior and 9 bileaflet prolapse. The number of artificial chordae was 1 in 10 cases, 2 in 39 cases, and 3 in 4 cases. The base of the artificial chordae was attached to the anterior leaflet in 11, posterior in 26, and both in 16. Twenty-two cases required no additional procedures and were completed with the Rechord system alone, and twenty three cases required additional procedures such as plication, indentation closure, and commissure closure. Four cases required a loop as an additional artificial chordae. All mitral valve repairs were successfully performed, and there was no mortality. Postoperative echocardiography MR grade was none in 10, trivial in 38, and mild in 5 patients. Although one patient with Barlow disease required repeat mitral valve repair four years after surgery, MR in all other cases was controlled very well.
CONCLUSIONS: Mitral valve repair using the Memo 3D/4D Rechord system is easy to adjust the length of the artificial chordae, and has good early and long-term results. This system is useful and considered to be one of the effective options in minimally invasive right thoracotomy approach cases.
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