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OBJECTIVE: We aimed to compare the outcomes of patients undergoing elective double valve surgery via a minimally invasive approach with those who had a standard median sternotomy.
METHODS: We retrospectively reviewed all heart surgeries performed at our institution from December 2005 to December 2011, and identified 197 patients who underwent primary double-valve surgery. The outcomes of those who had minimally invasive valve surgery through a right minithoracotomy were compared with those who had a median sternotomy.
RESULTS: Of the 197 patients, 117 (59%) underwent a minimally invasive approach, while 80 (41%) had a median sternotomy. The baseline characteristics were similar between the groups. The in-hospital mortality in the minimally invasive group was 2% (1/117) versus 10% (8/80) in the median sternotomy group, (p=0.009). The number of patients who received blood products was 83 (71%) in the minimally invasive group, and 78 (98%) in the median sternotomy group, p <0.01. The median intensive care unit length of stay was 70 hours (IQR 46-135) in the minimally invasive group, and 114 (IQR 70-214) in the median sternotomy group, (p<0.001). The post-operative hospital length of stay was less in the minimally invasive group: 12 ± 12 days versus 18 ± 16 days, p=0.003. The post-operative complications were 66 (56%) in the minimally invasive group and 62 (78%) in the median sternotomy group, p=0.002; with the difference being driven by a reduction in the incidence of sepsis of 3 (2%) versus 9 (11%), p=0.01, and post-operative atrial fibrillation of 15 (13%) versus 24 (30%), p=0.003 in the minimally invasive group and the median sternotomy group, respectively.
CONCLUSIONS: A minimally invasive approach for patients undergoing double valve surgery reduces morbidity, mortality, and resource utilization when compared with median sternotomy.