Minimally Invasive Mitral Valve Surgery
Mustafa Bahadır İnan, Mustafa Serkan Durdu, Mehmet Çakıcı, Evren Özçınar, Çağdaş Baran, Alper Özgür, Fatih Gümüş, Ahmet Rüçhan Akar.
Ankara University, Ankara, Turkey.
OBJECTIVE: Minimally invasive mitral valve surgery has gained popularity over the last decade. In this study we reported the early outcomes of patients undergoing minimally invasive mitral valve surgery(MI-MVS).
METHODS: All the patients who underwent MI-MVS between January 2013 and November 2016 were included. Submammarian(n:73), and periareolar incisions(n:69) were performed for all patients. Cardiopulmonary bypass (CPB) was achieved peripherally. Quadrangular/triangular resection or artificial chorda techniques were combined with rigid ring annuloplasty for mitral repair.Patients were evaluated on early mortality, need for sternotomy, length of intensive care unit(ICU) and hospital stay.
RESULTS: 142 patients [M/F:56/86,Age:41.12±10.46] underwent MI-MVS.96 patients had rheumatoid and 46 had degenerative mitral valve disease(26/20, posterior leaflet/bileaflet prolapsus).36 patients underwent mitral valve replacement and 28 had mitral valve repair as unique procedure, while 78 patients underwent concomitant procedures such as tricuspid valve surgery(n:42, %29.5), atrial septal defect closure(n:4,%2.8) and surgical ablation for AF (n:87,%61.4).Mean left atrium size and mean systolic pulmonary artery pressure were 5.13±0.48cm and 51.96±12.79mmHg, respectively. There were no early deaths.2 patient(%1.4) reexplorated due to bleeding.6 patients (%4.2) underwent median sternotomy.ICU stay was 15.9±4.57, hours while hospital stay was 6.29±1.66 days.We performed radiofrequency or cryoablation combined with LA plication in AF patients of which 54 converted to sinus rhythm.Mean X-clamp and cardiopulmonary-bypass times were 57.9±6.06 and 96.8±8.12 minutes,respectively
CONCLUSIONS: Minimally invasive approach is a safe and effective alternative to full sternotomy. It can be performed on a large population with very few perioperative complications.
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