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Issue: Vol. 56
Section: Research Article
DOI: 10.47972/vjcts.v56i.1802
Date Published: 31/07/2026
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Downloads 35
How to Cite
Pham, T. D., Nguyen, C. H., Nguyen, H. N., Doan, V. N., Bui, T. H., & Nguyen, T. H. (2026). Technical Characteristics and Outcomes of Totally Endoscopic Mitral Valve Repair for Isolated Posterior Leaflet Lesions: A Single-Center Study. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 56, 133 - 143. https://doi.org/10.47972/vjcts.v56i.1802

Technical Characteristics and Outcomes of Totally Endoscopic Mitral Valve Repair for Isolated Posterior Leaflet Lesions: A Single-Center Study

Thanh Dat Pham1, , Cong Huu Nguyen1, Hoang Nam Nguyen1, Van Nghia Doan1, Thanh Hung Bui1, Thi Huong Nguyen1
1 Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, E Hospital

Main Article Content

Abstract

Objective
This study aimed to describe repair techniques and evaluate early and mid-term outcomes of totally endoscopic mitral valve repair for primary mitral regurgitation caused by isolated posterior leaflet lesions.


Methods
A retrospective descriptive study was conducted on 183 consecutive patients with primary mitral regurgitation caused by isolated posterior leaflet lesions who underwent totally endoscopic mitral valve repair at the Cardiovascular Center, E Hospital, from January 2021 to June 2025. Patients with rheumatic mitral disease, anterior leaflet involvement, bileaflet lesions, or intraoperative conversion to mitral valve replacement were excluded. Surgical techniques were selected according to lesion morphology and included triangular resection, quadrangular resection, folding repair, commissural repair, vegetation resection, annular decalcification, artificial chordal implantation, and annuloplasty when indicated. Early postoperative outcomes and mid-term follow-up results were analyzed.


Results
The mean age was 55.7 ± 12.6 years, and 67.2% of patients were male. Severe mitral regurgitation was present in 97.8% of patients before surgery. Carpentier type II dysfunction predominated, accounting for 96.7% of cases. The most frequent lesion was chordal rupture, observed in 85.8%, and P2 was the most commonly involved segment. Triangular resection, quadrangular resection, and folding repair were the most frequently used repair techniques. The mean aortic cross-clamp and cardiopulmonary bypass times were 72 ± 24 minutes and 120 ± 30 minutes, respectively. Early mortality occurred in one patient, representing 0.5%. Predischarge echocardiography showed no moderate or severe residual mitral regurgitation. At mid-term follow-up, available in 169 patients, 97.0% remained free from moderate-or-greater recurrent mitral regurgitation, and only one patient required reoperation.


Conclusion
Totally endoscopic mitral valve repair for isolated posterior leaflet lesions is feasible, safe, and effective. In appropriately selected patients, this approach provides excellent early repair quality, low perioperative morbidity, and favorable mid-term durability.

Keywords

endoscopic mitral valve repair, posterior leaflet, mitral regurgitation, minimally invasive cardiac surgery, mitral valve repair, degenerative mitral valve disease

Article Details

References

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