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Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
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OBJECTIVES We sought to review our experience in patients with severely impaired left ventricular function (ejection fraction (EF) ≤ 30%) who underwent minimally invasive mitral valve (MV) surgery (Mini-MV).METHODS Between 1999 and 2010, a total of 3450 patients underwent Mini-MV surgery at our institution. Of these, 177 had severely impaired left ventricular function (EF < 30%, including ischaemic and non-ischaemic cardiomyopathy). Primary indication for surgery was MV regurgitation in all but 5 patients (2.8%), who were diagnosed with mixed regurgitation and stenosis. Mean age of patients was 67 ± 11 years and 110 were male (62.1%). Mean EuroSCORE predicted risk of mortality was 14.7 ± 13.6%.RESULTS MV repair was accomplished in 86.4% of patients (n = 153), and MV replacement was performed in 13.6% (n = 24). Primary MV repair included implantation of a rigid annuloplasty ring (mean size 29.5 ± 2.2 mm) in 95.4% of patients, and additional MV procedures as required. Concomitant procedures consisted of tricuspid valve surgery in 15.3% of patients, atrial fibrillation ablation in 27.1% and atrial septal defect/persistent foramen ovale closure in 5.6%. The duration of cardiopulmonary bypass was 123 ± 64 min and aortic cross-clamp time was 67 ± 27 min. Thirty-day mortality was 7.9%. The mean follow-up time was 3 ± 2.5 years, and the follow-up was 94.0% complete. Ten-year survival was 45.5% (95% CI: 35.2–55.9) for the overall group. The rate of MV-related reintervention was 4%, while heart transplantation was performed in 6%.CONCLUSIONS Mini-MV surgery in patients with significantly impaired left ventricular function can be performed with a reasonable operative mortality and acceptable long-term survival for this high-risk patient cohort.
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