Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective

Objectives: The present study assessed the late results of the operation, which consisted of the construction of a stentless mitral valve using autologous pericardium and valve implantation. Methods: Between 2011 and 2018, among 1617 consecutive patients who underwent mitral valve operation at our i...

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Main Authors: Tomoki Shimokawa, MD, Hitoshi Kasegawa, MD, Minoru Tabata, MD, MPH, Toshihiro Fukui, MD, Hajime Kin, MD, Atsushi Shimizu, MD, Tomoya Uchimuro, MD, Kenta Zaikokuji, MD, Schuichiro Takanashi, MD
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250724000762
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author Tomoki Shimokawa, MD
Hitoshi Kasegawa, MD
Minoru Tabata, MD, MPH
Toshihiro Fukui, MD
Hajime Kin, MD
Atsushi Shimizu, MD
Tomoya Uchimuro, MD
Kenta Zaikokuji, MD
Schuichiro Takanashi, MD
author_facet Tomoki Shimokawa, MD
Hitoshi Kasegawa, MD
Minoru Tabata, MD, MPH
Toshihiro Fukui, MD
Hajime Kin, MD
Atsushi Shimizu, MD
Tomoya Uchimuro, MD
Kenta Zaikokuji, MD
Schuichiro Takanashi, MD
author_sort Tomoki Shimokawa, MD
collection DOAJ
description Objectives: The present study assessed the late results of the operation, which consisted of the construction of a stentless mitral valve using autologous pericardium and valve implantation. Methods: Between 2011 and 2018, among 1617 consecutive patients who underwent mitral valve operation at our institution, 15 adult patients (0.9%) with unrepairable mitral valves who wished to avoid conventional mitral valve replacement underwent this operation. Ten patients (67%) had a history of valve repair. After discharge, patients were prospectively followed-up with a echocardiographic evaluation up to the end point. The mean follow-up term was 70.8 ± 42.5 months. Results: There were no hospital deaths or thromboembolic events and only 1 late noncardiac death. Intraoperative transesophageal echocardiography of all patients revealed no or trivial mitral regurgitation. Eight patients (53.3%) underwent redo valve replacement within 12 years. Except 1 late death, the postoperative course was divided into 3 groups depending on the occurrence of redo surgery, as follows: an early reoperation group (reoperation within 4 years; n = 4), a late reoperation group (reoperation after 4 years; n = 4), and a free from reoperation group (n = 6). The latest transthoracic echocardiographic examination performed 7.2 ± 2.9 years after the operation revealed the grade of mitral regurgitation to be none in 2 patients, mild in 2 patients, mild to moderate in 1 patients, and moderate in 1 patient in the free from reoperation group. Conclusions: Despite the high incidence of reoperation, Normo operation can be a viable option during valve replacement, especially for young patients.
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spelling doaj-art-709f7f85577f44ea8c4c22e6637524612025-08-20T03:04:47ZengElsevierJTCVS Techniques2666-25072024-06-0125556210.1016/j.xjtc.2024.02.020Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspectiveTomoki Shimokawa, MD0Hitoshi Kasegawa, MD1Minoru Tabata, MD, MPH2Toshihiro Fukui, MD3Hajime Kin, MD4Atsushi Shimizu, MD5Tomoya Uchimuro, MD6Kenta Zaikokuji, MD7Schuichiro Takanashi, MD8Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan; Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan; Address for reprints: Tomoki Shimokawa, MD, Department of Cardiovascular Surgery, Teikyo University, 2-11-1 Kaga Itabashi-Ku, Tokyo 173-8606, Japan.Department of Cardiac Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, JapanDepartment of Cardiovascular Surgery, Juntendo University, Tokyo, JapanDepartment of Cardiovascular Surgery, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Surgery, Iwate University, Iwate, JapanDepartment of Cardiac Surgery, Kawasaki Saiwai Hospital, Kanagawa, JapanDepartment of Cardiac Surgery, Kawasaki Saiwai Hospital, Kanagawa, JapanDepartment of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, JapanDepartment of Cardiac Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan; Department of Cardiac Surgery, Kawasaki Saiwai Hospital, Kanagawa, JapanObjectives: The present study assessed the late results of the operation, which consisted of the construction of a stentless mitral valve using autologous pericardium and valve implantation. Methods: Between 2011 and 2018, among 1617 consecutive patients who underwent mitral valve operation at our institution, 15 adult patients (0.9%) with unrepairable mitral valves who wished to avoid conventional mitral valve replacement underwent this operation. Ten patients (67%) had a history of valve repair. After discharge, patients were prospectively followed-up with a echocardiographic evaluation up to the end point. The mean follow-up term was 70.8 ± 42.5 months. Results: There were no hospital deaths or thromboembolic events and only 1 late noncardiac death. Intraoperative transesophageal echocardiography of all patients revealed no or trivial mitral regurgitation. Eight patients (53.3%) underwent redo valve replacement within 12 years. Except 1 late death, the postoperative course was divided into 3 groups depending on the occurrence of redo surgery, as follows: an early reoperation group (reoperation within 4 years; n = 4), a late reoperation group (reoperation after 4 years; n = 4), and a free from reoperation group (n = 6). The latest transthoracic echocardiographic examination performed 7.2 ± 2.9 years after the operation revealed the grade of mitral regurgitation to be none in 2 patients, mild in 2 patients, mild to moderate in 1 patients, and moderate in 1 patient in the free from reoperation group. Conclusions: Despite the high incidence of reoperation, Normo operation can be a viable option during valve replacement, especially for young patients.http://www.sciencedirect.com/science/article/pii/S2666250724000762mitral valve repairmitral valve replacementstentless mitral valveNormo valveautologous pericardium
spellingShingle Tomoki Shimokawa, MD
Hitoshi Kasegawa, MD
Minoru Tabata, MD, MPH
Toshihiro Fukui, MD
Hajime Kin, MD
Atsushi Shimizu, MD
Tomoya Uchimuro, MD
Kenta Zaikokuji, MD
Schuichiro Takanashi, MD
Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective
JTCVS Techniques
mitral valve repair
mitral valve replacement
stentless mitral valve
Normo valve
autologous pericardium
title Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective
title_full Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective
title_fullStr Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective
title_full_unstemmed Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective
title_short Long-term follow-up of repair-like replacement of mitral valve using autologous pericardiumCentral MessagePerspective
title_sort long term follow up of repair like replacement of mitral valve using autologous pericardiumcentral messageperspective
topic mitral valve repair
mitral valve replacement
stentless mitral valve
Normo valve
autologous pericardium
url http://www.sciencedirect.com/science/article/pii/S2666250724000762
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