Optimizing mitral valve repair outcomes: Embracing artificial chordae in minimally invasive procedures

This study aims to assess the efficacy of minimally invasive mitral valve repair (MIMVR) using artificial chordae in managing primary mitral regurgitation (MR) and refining surgical techniques. We conducted a retrospective analysis at the Ho Chi Minh City University of Medicine and Pharmacy Hospital, involving 106 patients with severe MR due to degenerative valve disease, treated from March 2017 to June 2023. All patients underwent MIMVR via a minimally invasive right thoracotomy, utilizing artificial chordae. Detailed echocardiographic assessments were performed preoperatively, perioperatively, and during follow-ups, alongside the collection of operative data for statistical analysis. The study cohort was predominantly male (75.5 %), with an average age of 50.7 years. Fibroelastic deficiency was the primary cause of MR, affecting 83 % of patients. An average of 2.7 chordae pairs per patient was used, and the mean annuloplasty ring size was 30.7 mm. No in-hospital deaths or mitral valve-related reoperations were reported. At discharge, 88.7 % of patients exhibited normal or mild MR. During an average follow-up of 28.2 months, mortality was 1.9 %, and 1 % of patients required reoperation due to mitral valve issues. Kaplan–Meier analysis showed freedom from severe recurrent MR at 1, 2, and 4 years to be 97 %, 94 %, and 91 %, respectively. MIMVR using artificial chordae demonstrates promising midterm outcomes for severe MR, emphasizing the importance of surgical precision. Further studies should refine techniques and address complications to ensure long-term effectiveness in mitral valve repair.