Background This study investigated the feasibility of a novel preformed artificial chordae tendineaes(ACTs) implantation device (Halochord) for mitral valve repair(MVP) via apical access. Methods Nine pigs were randomly divided into three groups: A, B, and C, and survived for 1, 3, and 6 months after surgery, respectively. The ACTs were anchored in the leaflet throught Halochord, adjusted to the correct length to cause moderate MR guided by echocardiography, and secured at the epicardium. Echocardiography was used to assess hemodynamic data and valve function. Surviving pigs were killed at the end of the follow-up period to confirm the deployment of ACTs. Results The modeling was successful, with no operative mortality. According to the echocardiographic and the cardiac anatomical specimen, all ACT implantation sites were found in the P2 region of MV. No rupture of the ACTs was detected during the observation period. Additionally, the ACTs gradually internalized as time passed, particularly at their extremities. Conclusions We demonstrated that off-pump ACTs implantation from the LV apex is a feasible and reproducible procedure.

Objectives: This study aimed to compare early and long-term outcomes of redo isolated tricuspid surgery (RITS) after left-sided valve surgery (LSVS). Methods: We retrospectively reviewed 173 patients underwent RITS for severe tricuspid regurgitation after previous LSVS from January 1999 to December 2019. Patients were divided into two groups: RITS by median sternotomy (m-RITS, n = 78) and by totally endoscopic approach (e-RITS, n = 95). Perioperative outcomes and follow-up results were analyzed. Results: There were 19 (11%) in-hospital deaths (14.1% in m-RITS and 8.4% in e-RITS, p = 0.234) that decreased from 16.7% (1999–2014) to 6.9% (2015–2019) (p = 0.044). Tricuspid valve replacement [odds ratio (OR) = 6.778, 95% confidence interval (CI): 1.370–33.549, p = 0.019] and NYHA function class IV (OR = 8.525, 95% CI: 2.153–33.760, p = 0.002) were independent risk factors of in-hospital mortality. The overall 1-, 5-year, 10-year, and 15-year survival rates were 97.2% (95% CI: 94.5–99.9%),80.3% (95% CI: 71.7–88.9%), 59.2% (95% CI: 43.5–75.5%) and 49.3% (95% CI: 27.2–71.4%), respectively. Conclusion: Patients undergoing redo isolated tricuspid valve surgery carry a high risk of early mortality. Satisfactory results are achievable with endoscopic tricuspid valve surgery and repair results in lower surgical mortality than replacement with acceptable residual tricuspid regurgitation.

Objectives: To explore the safety and efficacy of total thoracoscopic repair of ventricular septal defects (VSD). We compared clinical outcomes of VSD via a total thoracoscopic approach with those of mini-sternotomy. Methods: We retrospectively reviewed clinical data from patients with VSD from 2012 to January 2019. According to the surgical pattern, they were divided into two groups: the total thoracoscopic surgery group (36 patients, 27 females, aged 29.08 ± 9.52 years), and a mini-sternotomy group (31 patients, 12 females, aged 28.39 ± 8.67 years). Results: There were no deaths in either group. In the thoracoscopic group, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were significantly longer than those of the mini-sternotomy group (CPB time: 111.78 ± 23.16 min vs 77.58 ± 37.90 min, respectively, p < 0.001; ACC time: 111.78 ± 23.16 min vs 77.58 ± 37.90 min, respectively, p < 0.001). Tracheal intubation time (6.42 ± 3.85 hours vs 28.55 ± 123.18 hours, p = 0.325), intensive care unit (ICU) stay time (20.47 ± 9.52 hours vs 49.65 ± 163.72 hours, p = 0.330), postoperative hospital stay time (5.11 ± 2.48 days vs 5.90 ± 6.27 days, p = 0.488) and chest drainage (139.86 ± 111.71 ml vs 196.13 ± 147.34 ml, p = 0.081) tended to be lower in the thoracoscopy group, although there was no significant difference. No residual shunt or tricuspid regurgitation was found at follow-up. Conclusions: Total thoracoscopic repair is safe and effective in patients with VSD, with or without tricuspid regurgitation.