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OBJECTIVE: Minimally Invasive Mitral valve surgery through right minithoractomy using endovascular cardiopulmonary bypass via femoral vessels is widely practiced in the last decade. Increased rate of stroke amongst other complications was implicated with use of the aortic Endobaloon in the early studies. This study reports the early complications resulting from the use of the aortic Endobaloon catheter from a large series of patients.
METHODS: Single centre data of patients who underwent primary, Port access, Mitral valve surgery with the use of Endoballoon (Edwards inc) were reviewed. Data was collected from 2007 to mid 2013 and Endoballoon related groin and neurovascular complications within 6 weeks of surgery were recorded and analysed.
RESULTS: 1201 patients (male 52%; age 65±13yrs; BMI 25±4.5; BSA 1.86±0.22) underwent endoscopic mitral valve surgery [repair 1%, ring 28%, repair&ring 58%, replacement 13% (mechanical 34%, biological 66%)]. 26% of patients had concomitant tricuspid valve procedures. Total hospital stay was 11.2±5.9days (pre-op 1.4±1.4days; post-op 9.8±5.8days). There were no aortic dissections; three groin haematomas (0.25%); two patients required embolectomy (0.2%); six groin infection (0.5%); two groin lymphocoele (0.2%) and one groin pseudoaneurysm (0.1%). Neurovascular complications comprised of twelve strokes (1%) and two transient ischaemic attacks (0.2%). The total six weeks mortality was 22(1.8%).
CONCLUSIONS: Our experience suggests that with better understanding and frequent use, Endovascular balloons can be safely used in patients undergoing minimally invasive mitral valve procedure with remarkably low peri-operative and early post operative complications