{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T03:55:44Z","timestamp":1771646144590,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,3,28]],"date-time":"2020-03-28T00:00:00Z","timestamp":1585353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Previous series of minimally invasive mitral valve repairs showed excellent results at up to 10\u2009years of follow-up. The goal of this study was to assess the long-term durability beyond 10\u2009years of the edge-to-edge repair for myxomatous degeneration performed through a minimally invasive approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Ninety-seven consecutive patients (mean age 35\u2009\u00b1\u20099\u2009years; left ventricular ejection fraction 63\u2009\u00b1\u20096%) with severe myxomatous mitral regurgitation (MR) underwent mitral valve repair through a right minithoracotomy between 1999 and 2006. MR was due to lesions involving the posterior leaflet (7.2% of patients), anterior leaflet (12.4%) and both leaflets (80.4%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>No hospital deaths occurred. At hospital discharge all patients had no or trivial MR. Follow-up was 100% complete (median 15.5\u2009years; interquartile range 13.6\u201317.0, max 19.3\u2009years). The 16-year overall survival rate was 95.9\u2009\u00b1\u20092.02% [95% confidence interval (CI) 89.39\u201398.43]. At 16\u2009years, the cumulative incidence function of cardiac death, with non-cardiac death as a competing risk, was 3.1\u2009\u00b1\u20091.75 (95% CI 0.83\u20138.02). Only 3 patients (4.1%) had redo operations for recurrent severe MR. At 16\u2009years, the cumulative incidence functions of reoperation for and recurrence of MR \u22653+, with death as a competing risk, were 3.1\u2009\u00b1\u20091.76% (95% CI 0.83\u20138.02) and 5.6\u2009\u00b1\u20092.47% (95% CI 2.06\u201311.83), respectively. No predictors of recurrence of MR \u22653+ were identified. At the last follow-up, moderate MR (2+\/4+) was detected in 17 patients (17.5%); most of the patients were in New York Heart Association functional class I\u2013II (97%) and in sinus rhythm (90%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Minimally invasive mitral valve edge-to-edge repair through a right minithoracotomy for myxomatous degeneration appears to be an effective and durable approach even in the long-term follow-up (up to 19\u2009years).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaa048","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T12:14:18Z","timestamp":1582028058000},"page":"28-34","source":"Crossref","is-referenced-by-count":13,"title":["Excellent long-term results with minimally invasive edge-to-edge repair in myxomatous degenerative mitral valve regurgitation"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4618-7520","authenticated-orcid":false,"given":"Igor","family":"Belluschi","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Lapenna","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Blasio","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0081-6232","authenticated-orcid":false,"given":"Benedetto","family":"Del 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Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Castiglioni","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottavio","family":"Alfieri","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9329-7437","authenticated-orcid":false,"given":"Michele","family":"De Bonis","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, 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