Single-Center Experience of Transapical Mitral Valve Repair: Preliminary Results

Background: Minimally invasive mitral valve repair evolved into gold standard for degenerative mitral valve disease. However, transapical neochord implantation on the beating heart allows for increasing treatment options in patients how are not eligible for on pump surgery.

Method: Thirteen consecutive patients with severe mitral regurgitation (MR) due to isolated P2 prolapse were screened and treated for transapical mitral valve repair in our center. Between three and five artificial expanded polytetrafluoroethylene cords (ePTFE) were implanted per patient using a transesophageal echocardiography-guided device via small anterolateral left thoracotomy. Mean age was 68 years, all were male patients, and all patients were in NYHA class 1–2.

All patients agreed to participate in follow-up (1 month, 1–5 years).

Results: Procedural success rate was 100% without any complications. Implant time was 35 minutes (18–42 minutes), skin to skin time was 102 minutes (68–138 minutes). MR was reduced from severe to trace on 11 patients, in 1 to absent and in another 1 to mild. The anterior-posterior annular diameter decreased between 1 to 4 mm postimplantation. Hospital stay was 4 days.

At the 30-day follow-up, all patients were in NYHA class I without any changes in MR grade.

Conclusion: Transapical beating heart mitral valve repair is a safe and effective treatment option for patients who are not eligible for on-pump mitral valve surgery. Procedural preliminary results are very promising, but further follow-up data have to proof our exciting results.

Publication History

Article published online:
03 February 2022