Loop technique with ink-dot marking test: An alternative strategy to the ink test.

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Surgical Techniques

Background:

• Mitral valve (MV) repair aims to restore normal valve function and improve patient outcomes.
• The loop technique is a method for MV repair, but optimizing leaflet height alignment is crucial.
• The ink-dot marking test is an alternative to the traditional ink test for precise leaflet alignment.

Purpose of the Study:

• To assess the long-term efficacy of the loop technique for mitral valve repair using the ink-dot marking test.
• To evaluate the impact of the ink-dot marking test on reducing residual mitral regurgitation (MR).

Main Methods:

• Retrospective review of 351 patients undergoing MV repair with the loop technique.
• Utilized the ink-dot marking test with gentian violet for leaflet alignment.
• Adjusted loop fixation with or without loop-in-loop and neochordal repair based on markings.

Main Results:

• Predischarge echocardiography revealed trivial MR in 285 patients, mild in 64, and moderate in 2.
• Ten patients required reoperation due to recurrent MR during follow-up.
• The 3-, 5-, and 10-year cumulative incidence of moderate to severe recurrent MR was 3.6%, 6.0%, and 19.8%, respectively.

Conclusions:

• The loop technique combined with the ink-dot marking test demonstrates favorable early and long-term results in MV repair.
• This marking test appears to be beneficial in minimizing residual MR.
• The technique is a valuable option for mitral valve repair surgeons.