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ONE YEAR CLINICAL RESULTS OF THE ECHO GUIDED TRANSAPICAL MITRAL VALVE REPAIR WITH NEOCHORD IMPLANTATION
2192 JACC April 5, 2016 Volume 67, Issue 13
Valvular Heart Disease ONE YEAR CLINICAL RESULTS OF THE ECHO GUIDED TRANSAPICAL MITRAL VALVE REPAIR WITH NEOCHORD IMPLANTATION Moderated Poster Contributions Valvular Heart Disease Moderated Poster Theater, Poster Area, South Hall A1 Monday, April 04, 2016, 1:30 p.m.-1:40 p.m. Session Title: Mitral Regurgitation: New Information and Options Abstract Category: 41. Valvular Heart Disease: Therapy Presentation Number: 1284M-09 Authors: Andrea Colli, Eleonora Bizzotto, Laura Besola, Erica Manzan, Fabio Zucchetta, Roberto Bellu, Cristiano Sarais, Lorenzo Bagozzi, Matteo Montagner, Demetrio Pittarello, Dario Gregori, Gino Gerosa, University of Padua, Padua, Italy Background: Transapical Off-Pump mitral valve repair with Neochord implantation (TOP-MINI) is an innovative minimally invasive procedure to treat degenerative mitral regurgitation (MR) due to prolapse or flail.
Methods: Clinical and echocardiographic outcomes of consecutive patients through 1 year follow-up (FU) were obtained from the Institutional database. Events were analysed according to the latest Mitral Valve Academic Research Consortium (MVARC) consensus report.
Results: From November 2013 to September 2015, 79 consecutive patients with severe MR underwent TOP-MINI procedure. A 30-days FU was obtained for 72 patients, whilst 58 and 41 reached respectively 6-month and 1-year FU. Median age was 70 years (IQR 59-77), median STS score was 1,11% (IQR 0,5-2). Seventy patients (89%) had a posterior leaflet disease, 6 (8%) an anterior leaflet disease and 3 (4%) a combined disease. Three neochordae were implanted in 22 (28%) patients, 4 in 37 (47%), 5 in 14 (6%), 6 in 5 patients (6%) and 8 in 1 (1%). MVARC technical success was achieved in 78 (99%). MVARC early structural failure and functional failure were 1 (1,3%) in both cases. At 30-day FU MVARC procedural success was achieved for 69 (96%) patients. Two (3%) all-cause periprocedural death occurred (compassionate cases). MVARC device success was achieved for 69 (96%). At 6-month FU MVARC device success was reached for 57 patients (98%). Three patients presented a recurrence of moderate to severe MR, two were reoperated and one was not reoperated because of good clinical status. At 1-year FU MVARC device success was reached for 39 patients (95%) and MVARC patient success was reached for 39 (95%). One patient (2%) presented a recurrence of moderate to severe MR and underwent surgery and 1 patient (2%) presented recurrence of moderate to severe MR but was not reoperated because of good clinical status and high surgical risk (STS 9%). Conclusions: Transapical off-pump echo guided mitral valve repair with neochord implantation is a safe surgical option, with acute good clinical and echocardiographic results. Results are stable over time providing good long term survival
Valvular Heart Disease ONE YEAR CLINICAL RESULTS OF THE ECHO GUIDED TRANSAPICAL MITRAL VALVE REPAIR WITH NEOCHORD IMPLANTATION Moderated Poster Contributions Valvular Heart Disease Moderated Poster Theater, Poster Area, South Hall A1 Monday, April 04, 2016, 1:30 p.m.-1:40 p.m. Session Title: Mitral Regurgitation: New Information and Options Abstract Category: 41. Valvular Heart Disease: Therapy Presentation Number: 1284M-09 Authors: Andrea Colli, Eleonora Bizzotto, Laura Besola, Erica Manzan, Fabio Zucchetta, Roberto Bellu, Cristiano Sarais, Lorenzo Bagozzi, Matteo Montagner, Demetrio Pittarello, Dario Gregori, Gino Gerosa, University of Padua, Padua, Italy Background: Transapical Off-Pump mitral valve repair with Neochord implantation (TOP-MINI) is an innovative minimally invasive procedure to treat degenerative mitral regurgitation (MR) due to prolapse or flail.
Methods: Clinical and echocardiographic outcomes of consecutive patients through 1 year follow-up (FU) were obtained from the Institutional database. Events were analysed according to the latest Mitral Valve Academic Research Consortium (MVARC) consensus report.
Results: From November 2013 to September 2015, 79 consecutive patients with severe MR underwent TOP-MINI procedure. A 30-days FU was obtained for 72 patients, whilst 58 and 41 reached respectively 6-month and 1-year FU. Median age was 70 years (IQR 59-77), median STS score was 1,11% (IQR 0,5-2). Seventy patients (89%) had a posterior leaflet disease, 6 (8%) an anterior leaflet disease and 3 (4%) a combined disease. Three neochordae were implanted in 22 (28%) patients, 4 in 37 (47%), 5 in 14 (6%), 6 in 5 patients (6%) and 8 in 1 (1%). MVARC technical success was achieved in 78 (99%). MVARC early structural failure and functional failure were 1 (1,3%) in both cases. At 30-day FU MVARC procedural success was achieved for 69 (96%) patients. Two (3%) all-cause periprocedural death occurred (compassionate cases). MVARC device success was achieved for 69 (96%). At 6-month FU MVARC device success was reached for 57 patients (98%). Three patients presented a recurrence of moderate to severe MR, two were reoperated and one was not reoperated because of good clinical status. At 1-year FU MVARC device success was reached for 39 patients (95%) and MVARC patient success was reached for 39 (95%). One patient (2%) presented a recurrence of moderate to severe MR and underwent surgery and 1 patient (2%) presented recurrence of moderate to severe MR but was not reoperated because of good clinical status and high surgical risk (STS 9%). Conclusions: Transapical off-pump echo guided mitral valve repair with neochord implantation is a safe surgical option, with acute good clinical and echocardiographic results. Results are stable over time providing good long term survival