ISMICS 17 Annual Scientific Meeting, 7-10 June 2017, Rome Cavalieri, Rome, Italy
ISMICS 17 Annual Scientific Meeting, 7-10 June 2017, Rome Cavalieri, Rome, Italy
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Mitral Valve Repair by Minimally Invasive Approach In A Colombian Center
Lizeth Dayana Saldaña Morales, Alberto Alejandro Quintero Gómez, Jose Julian Escobar Matallana, Juan Camilo Rendón Isaza, Juan Santiago Jaramillo Isaza.
Clinica Cardio VID, Medellin, Colombia.

OBJECTIVE: Mitral valve repair is the technique of choice in patients with mitral regurgitation, 95% of success excellence centers. The objective is to describe minimally invasive mitral valve repair results in our institution.
METHODS: Retrospective descriptive observational study of mitral valve repair performed by minimally invasive surgery from January 2013 to November 2016. The results are described at 30 postoperative days.
RESULTS: We performed 225 mitral valve surgeries through a minimally invasive approach, 114 replacement and 111 repair. 97.3% (108/111) were successful repair and 2.7% (3/111) of the patients required conversion to sternotomy. 77.5% (86/111) were male. The average age was 55.4 ± 11.9 years (24 - 78). The body mass index was 24.7 ± 3.6 (17-35). The surgery was elective in 98.2% (109/111). Etiology valve was degenerative-myxomatous in 92.8% (103/111). The median ejection fraction was 60% (20-78%), with severe insufficiency in 81.1% (90/111) of the cases. The right lateral mini thoracotomy approach was 88.3% (98/111) and the periareolar 9% (10/111). Ring annuloplasty was performed in 99% (109/110) of patients. Technically, we perform neochordae in 78.2% (86/110) and resection in 22.7% (25/110) of patients. We found affected posterior leaflet in 72% (79/111). Additional procedures in 12% (13/111) (including tricuspid repair, foramen ovale / inter atrial communication closure, maze procedure) We had one (1/111) failed repair by systolic anterior motion (SAM). The mean time for aortic cross clamping was 103 ± 30 (34-228) and perfusion 148 ± 42 (71-293) minutes. Transthoracic echocardiography before discharge reports: no mitral regurgitation in 68% (75/110), trivial 17% (19/110), mild 13% (14/110), moderate 2% (2/110) of the cases. Major adverse events were: 1(0.9%) SAM, 4(3.6%) reintervention due to bleeding, 1(0.9%) postoperative endocarditis, 1(0.9%) postoperative acute infarction, 4(3.6%) Acute renal failure (Dialysis), 4(3.6%), 2(1.80%) abdominal surgical complications. The median stay in the Intensive Care Unit was 2 days (1-106) and 4 days (2-194) in-hospital. There were no deaths within 30 days postoperatively
CONCLUSIONS: The mitral valve repair by minimally invasive surgery is a safe technique in our institution, with comparable results of specialized centers in mitral valve repair.


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