Back to Annual Meeting ePosters

OBJECTIVE: The aim of this study was to analyse our experience over the years with minimally invasive mitral valve surgery (MIS-MVS) focussing on the perioperative mortality, morbidity and longterm durability and survival.
METHODS: We retrospectively analysed the outcome of 284 consecutive patients (age 54±11years, 33% females) who underwent an endoscopically enhanced MIS-MVS using a right anterolateral mini-thoracotomy and femoral cannulation for cardiopulmonary bypass where included in the study. All patients suffered from severe mitral regurgitation (3.3±0.59), with a maintained ejection fraction of 58.7±8.9%.
RESULTS: The success rate of the procedure was a 98.9% (1.06% conversion to full sternotomy). The repair rate was 96.1% (for isolated mitral regurgitation 98.2%). MV repair involved ring annuloplasty with or without cordae replacement and/or Carpentier type leaflet resection. Concomitant procedures: 2 patients additional tricuspid valve surgery (0.7%), 16 patients closure of atrial septal defect/ foramen ovale (5.6%), 30 patients atrial fibrillation ablation (10.5%). Mean aortic cross-clamp time was 115±37 min and mean cardiopulmonary bypass time 173±49 min. The postoperative ventilation time was 8.83±4.0 hours and the ICU stay was 2.14±1.2 days. Postoperative hospitalisation was 10.03±3.1 days.
The in-hospital mortality was 0.77% (n=2). At discharge degree of regurgitation was favourably reduced to grade 0 to grade 1 in 96.8%, up to grade 2 in 1.4% and > grade 2 in 1.7% of patients. Ejection fraction postoperatively remained unchanged (p=ns).
Postoperative complications were observed as followed: stroke (0.77%), re-exploration for bleeding (1.56%), pacemaker implantation (2.33%) and thoracic and inguinal wound complication (3.89%).
Follow-up was performed through our own outpatient clinic and the referring cardiologist. The long-term freedom from re-operation/ intervention and survival will be presented.
CONCLUSIONS: Minimally invasive mitral valve repair and replacement is a safe procedure with excellent short-and mid-term results.