Analysis on the long term results of total thoracoscopic minimally invasive mitral valvuloplasty in 1 275 patients with mitral regurgitation
ZHONG Lishan
HUANG Yanying
WANG Zhenzhong
XIAO Shuo
LI Yuxin
FANG Dou
WANG Qiuji
ZHANG Chaolong
HUANG Huanlei
Abstract：Objective To clarify the safety,efficacy and durability of total thoracoscopic minimally invasive mitral valvuloplasty(TCMI-MVP)in the treatment of mitral regurgitation(MR).Methods The medium and long term results of 1 275 MR patients who received TCMI-MVP in Guangdong Provincial People's Hospital from January 1,2009 to June 1,2022 were retrospectively analyzed.The patients were divided into non-recurrent MR group(group A,1 098 cases)and recurrent MR group(group B,177 cases)according to the follow-up results.The preoperative,intraoperative and postoperative data and the follow-up results were compared between the two groups.Results The follow-up rate was 96.24%,and the median follow-up time was 4.42(0.00,13.20)years.The 1-,3-,5-and 10-year survival rates of the patients in the entire cohort were 99.5%,98.5%,97.8%and 95.5%,respectively.There was no significant difference in survival prognosis between the two groups(χ2 =0.350,P=0.554).When death was not considered as a competing risk,the recurrent exemption rates of the patients for MR≥2+at 1 year,3 years,5 years and 10 years were 90.4%,87.4%,85.6%and 78.3%in the entire cohort,respectively.When death was considered as a competing risk,the cumulative incidence rates of postoperative progression with MR≥2+at 1 year,3 years,5 years and 10 years were 9.6%,12.5%,14.3%and 21.4%,respectively.Multivariate Cox regression analysis showed that suffering from high blood pressure[HR(95%CI)= 1.70(1.18-2.44),P=0.004],receiving simultaneous tricuspid valvuloplasty[HR(95%CI)= 1.65(1.16-2.36),P = 0.006],larger preoperative left ventricular end-systolic diameter[HR(95%CI)= 1.09(1.03-1.15),P=0.002],larger left atrial diameter 1 week after operation[HR(95%CI)= 1.03(1.01-1.06),P=0.031]and high MR grading 1 week after operation[HR(95%CI)= 59.63(21.84-162.82),P＜0.001]were risk factors for MR recurrence.The overall exemption rates of the patients for mitral valve reoperation at 1 year,3 years,5 years,and 10 years were 99.6%,98.9%,98.7%and 97.9%,respectively.Conclusion TCMI-MVP is safe and effective in ad-vanced valve centres using various repair techniques in a rational manner,and good long-term repair outcomes can be achieved.
Keywords：Mitral regurgitation(MR)Total thoracoscopic minimally invasiveMitral valvuloplasty(MVP)
Publication Date：2024-03-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 244-251 )