Send to

Choose Destination
See comment in PubMed Commons below
Ann Thorac Surg. 2013 Apr;95(4):1347-53. doi: 10.1016/j.athoracsur.2012.12.026. Epub 2013 Feb 28.

Minimally invasive edge-to-edge mitral repair with or without artificial chordae.

Author information

Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.



This study aims to analyze the midterm outcomes of minimally invasive edge-to-edge mitral valve repair (MVR) with artificial chords (CHORD) or without artificial chords (noCHORD) in patients with mitral regurgitation (MR).


Records of all patients undergoing edge-to-edge MVR through minithoracotomy at a single institution over a 7-year period were retrospectively reviewed.


A total of 186 patients underwent edge-to-edge MVR through minithoracotomy. Disease etiology was posterior prolapse in 73 (39%) and bileaflet prolapse in 77 (41%). Edge-to-edge sutures were used at A1-P1 in 20 patients (11%), A2-P2 in 136 (73%), and A3-P3 in 30 (16%). Annuloplasty rings were placed in 184 patients (99%), with a mean size of 36±5 mm. Mean follow-up was 2 years (range, 0 to 6), with mean mitral gradient 4±2 mm Hg, MR mild or less in 179 of 186 (96%), 4 (2%) late reoperations, and 1 (0.5%) late death. The CHORD patients (n=71) were more likely than the noCHORD patients (n=115) to have extensive posterior leaflet pathology (p<0.01), had longer clamp and pump times (p<0.01) and were less likely to need leaflet resection (p=0.002), but had similar postoperative courses. At 3 years, freedom from moderate MR was less in CHORD versus noCHORD patients (88±6 versus 100%, p=0.001), but freedom from reoperation was similar (96%±3% versus 99%±1%, p=not significant).


Early results suggest that edge-to-edge MVR can be safe and effective in patients with mitral regurgitation. Edge-to-edge MVR combined with artificial chordae may be useful in selected patients, but with some risk of recurrent moderate MR.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center