초록접수 현황
| 17F-192 | Video session발표 |
Totally Endoscopic Mitral Valve Repair
Jae Woong Lim, Chang Woo Choi, Keun Her, Hwa Kyun Shin
Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : Minimally invasive mitral valve surgery performed via right mini-thoracotomy has gained increasing acceptance as a safe technique. We report a case of totally endoscopic mitral valve repair in a patient with prolapsed posterior mitral leaflet.
Methods : A 48-year-old male patient was admitted due to exertional dyspnea (New York Heart Association functional class III) and pulmonary edema. The echocardiography showed severe mitral regurgitation with posterior leaflet prolapse involving the P1 segment.
Results : The operation was performed with totally endoscopic approach. A small thoracotomy (about 4cm) was made along the 4th intercostal space. Additional accessory port was made for aortic clamp, endoscope, left atrial retractor and left atrial vent cannula (Fig. 1). Cardioplegic arrest was achieved by application of 2000ml of Custodiol HTK solution.
A neochordoplasty of the P1 segment and commissuroplasty at anterolateral commissure was performed. The repair was completed with a implantation of a flexible annuloplasty band(Cosgrove-Edwards Annuloplasty System). Intraoperative transesophageal echocardiography confirmed the competency of the mitral valve. The crossclamp time was 160 minutes, and the total operation time was 450 minutes. The patient was transferred to the intensive care unit without inotropic support and was extubated 4 hours after the operation.
Conclusion : Totally endoscopic mitral valve repair is technically feasible and provides complete exposure of the mitral valve and offers a excellent cosmetic result. In addition, totally endoscopic approach result in less postoperative pain and fast recovery to work. More experience is needed to shorten the procedure time.
Methods : A 48-year-old male patient was admitted due to exertional dyspnea (New York Heart Association functional class III) and pulmonary edema. The echocardiography showed severe mitral regurgitation with posterior leaflet prolapse involving the P1 segment.
Results : The operation was performed with totally endoscopic approach. A small thoracotomy (about 4cm) was made along the 4th intercostal space. Additional accessory port was made for aortic clamp, endoscope, left atrial retractor and left atrial vent cannula (Fig. 1). Cardioplegic arrest was achieved by application of 2000ml of Custodiol HTK solution.
A neochordoplasty of the P1 segment and commissuroplasty at anterolateral commissure was performed. The repair was completed with a implantation of a flexible annuloplasty band(Cosgrove-Edwards Annuloplasty System). Intraoperative transesophageal echocardiography confirmed the competency of the mitral valve. The crossclamp time was 160 minutes, and the total operation time was 450 minutes. The patient was transferred to the intensive care unit without inotropic support and was extubated 4 hours after the operation.
Conclusion : Totally endoscopic mitral valve repair is technically feasible and provides complete exposure of the mitral valve and offers a excellent cosmetic result. In addition, totally endoscopic approach result in less postoperative pain and fast recovery to work. More experience is needed to shorten the procedure time.
책임저자: Jae Woong Lim
Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Jae Woong Lim, E-mail : jwlim@schmc.ac.kr