Author + information
- Andrea Colli1,
- Eleonora Bizzotto2,
- Erica Manzan3,
- Laura Besola3,
- Roberto Bellu2,
- Alessandro Fiocco2,
- Nicola Pradegan2,
- Matteo Nadali2 and
- Gino Gerosa3
Transapical off-pump mitral valve repair with neochordae implantation is a minimally invasive, safe and reproducible treatment for degenerative mitral valve regurgitation (MR). Aim of this study is to evaluate the 2 years clinical results according to morphological valve classifications.
152 patients with severe MR for flail/prolapse (November 2013-May 2017) were treated. They were divided in groups according to mitral valve anatomy: Type A: isolated P2 prolapse; Type B: posterior multisegment involvement; Type C: anterior leaflet; Type D: bi-leaflet, para-commissural disease, leaflet/annular calcifications. Primary endpoint was MVARC patient success: freedom from recurrence of MR>moderate /mortality/stroke/reintervention and rehospitalization and 30-days.
Median age was 65 years (IQR 54-75) and median STS 0.7% (IQR 0.34-1.66). Patients MV anatomy was distributed as follow: type A 65 (42.8%), type B 61 (40.1%), type C (9.2%), type D (7.9%). At 30-days MR≤moderate was present in 136 (96.5%) in the overall population, 63 (100%) in type A, 51 (94.4%) in type B, 12 (85.7%) in type C and 10 (100%) in type D. Two-years FU was completed for 64 (42%) patients. Overall 2-years survival was 98.6±1%. MVARC patient success was 84.1±3.4% for the overall population, 96±2.8% for type A, 82.7±5% for type B, 66.1±14.3% for type C and 57.1±17.2% for type D (p=0.006).
Current data show that TOP-MINI procedure is safe, and its efficacy is maintained up to 2-years according to MV preoperative anatomy.
STRUCTURAL: Valvular Disease: Mitral