On June 23, 2020, the team of Professor Chen Lianglong from the Department of Cardiology and Professor Chen Liangwan from the Department of Cardiology at Fujian Medical University Affiliated Union Hospital and Fujian Provincial Heart Medical Center, together with Professor Zhou Daxin, Deputy Director Pan Wenzhi, and Dr. Li Weiqiang from Academician Ge Junbo's team at Fudan University Affiliated Zhongshan Hospital, worked together to provide treatment for two elderly patients with severe mitral regurgitation; Esophageal ultrasound-guided transapical mitral valve clipping surgery; By avoiding traditional thoracotomy and extracorporeal circulation, both patients experienced mild mitral regurgitation after surgery, and the surgery was a complete success.

ValveClamp mitral valve clamp system surgical team, from left to right: Vice Director Pan Wenzhi, Professor Chen Liangwan, Professor Zhou Daxin, Professor Chen Lianglong, Vice Director Fang Jun, Dr. Qiu Zhihuang

The first case is an elderly male patient who was admitted due to repeated shortness of breath and chest tightness for one year, which worsened for one month. The echocardiogram evaluated P2 prolapse of the posterior leaflet of the mitral valve, tendon rupture with severe reflux. The cardiac surgery consultation considered open chest surgery to be high-risk, and the STS score was 10%. The patient made a small incision of 3cm at the apex of the heart under general anesthesia, and a ValveClamp clamp was implanted into the beating heart through a catheter. Immediately after the surgery, transesophageal ultrasound showed that the patient's reflux had decreased to mild. The total time from making the small incision at the apex to closing the incision was about 60 minutes, and the operation time through the apex catheter was only about 15 minutes.

The operator performs catheterization

Case 1: Preoperative mitral regurgitation was severe

Case 1: Postoperative mitral regurgitation was mild

The second case is an elderly female patient who was admitted to the hospital due to shortness of breath and heart murmurs after more than 3 years of activity. The echocardiographic evaluation showed P2 prolapse of the posterior leaflet of the mitral valve, small chordae tendineae rupture at P2 offset P1 with severe reflux. The cardiac surgery consultation considered open chest surgery to be high-risk, and the STS score was 6.1%. The patient was also implanted with a ValveClamp clamp under general anesthesia, and immediately after surgery, mitral regurgitation was reduced to mild, with less surgical time and no surgical complications.

Case 2 had severe preoperative mitral regurgitation

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Case 2: Postoperative mitral regurgitation was mild

The heart failure and pulmonary hypertension associated with severe mitral regurgitation increase the readmission and mortality rates of patients, and reduce their quality of life. The ValveClamp instrument used in this surgery is the first domestically developed minimally invasive interventional treatment instrument for mitral regurgitation that has entered pre-market clinical trials in China. Its surgery is a type of; Ultra minimally invasive surgery performed on a beating heart; First, make a 3cm incision in the precordial area, and under the guidance of cardiac ultrasound, puncture the heart and deliver instruments for surgical operation. This surgery is minimally invasive, does not require cardiac arrest or extracorporeal circulation, and therefore has higher safety, especially suitable for elderly patients who cannot tolerate traditional surgical procedures.

At present, ValveClamp has been carried out in more than ten authoritative heart centers in China, including Zhongshan Hospital in Shanghai, Zhejiang Second Hospital, Fuwai Hospital in Beijing, Guangdong Provincial People's Hospital, Xijing Hospital, Huaxi Hospital in Sichuan, Yaxin Hospital in Wuhan, and Anzhen Hospital in Beijing. We look forward to more patients with mitral regurgitation receiving this minimally invasive treatment.