Minimally invasive mitral valve surgery why do you take the risks?
Farouk Oueida, MD, Ahmed Attia, MD, Khalid Alkhamees, Khalid Eskander, Hassan Ammar, Mustafa Alrefaie, MD.
Saud Albabtain Cardiac Center, Dammam, Saudi Arabia.
OBJECTIVE: During recent years, minimally invasive mitral valve surgery(MIMVS ) become the preferred method of mitral valve repair and replacement in many institutions worldwide with excellent results.
However , There are no efficient studies about the risks of MIMVS comparing to conventional Mitral valve surgery .
We will present early and mid-term outcomes of patients undergoing minimally invasive mitral valve surgery in our institution .
METHODS: The patient’s demographic profile ,intraoperative data and postoperative outcomes of patients undergoing minimally invasive mitral valve surgery were retrospectively collected from our database from May 2011 to April 2014.
RESULTS: Seventy consecutive patients (45male and 25 female), age 35 +/- 12 years, underwent MIMVS surgery. Mean preoperative New York Heart Association function class was 2.6+/- 0.7. mean ejection fraction was 50+/- 8 . Cardiopulmonary bypass was instituted through femoral cannulation ( 28 of 70, 40%) , or direct aortic cannulation (42 of 70, 25%). aortic cross-clamp used in (66 of 70 , 94.2%) .without aortic cross-clamp in (4 of 70 , 5.7%), mitral valve repair has been done in (52 of 70, 74.2%), mitral valve replacement (18 of 70, 25.7 %), . Concomitant procedures included AF ablation (24of 70, 34.2%), and tricuspid valve repair (33of 70, 47.1%). No mortality recorded, residual mitral regurge was found in (6 of 70, 8.5%) during 1 year follow up .cardiopulmonary bypass, and "skin to skin" surgery were 95 +/- 35and 250 +/- 74minutes, respectively. 4 patients (5.7%) underwent reexploration for bleeding and (57 of 70, 81.4 %) did not receive any blood transfusions. Six patients (8.5%) sustained face oedema . Mean length of hospital stay was 7 +/- 3.8 days. 18 patients (25.7%) did not feel any interest regarding cosmotic advantage over conventional surgery
CONCLUSIONS: Minimally invasive mitral valve surgery is an excellent alternative to conventional mitral valve surgery in most cases however comparing to conventional mitral surgery it shows long bypass time , long cross clamp time , need for reexploration for bleeding and multiple body incisions.
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