Minimal Invasive Mitral Valve Surgery: Early Outcomes Of A Single Center
vincent Tchana-Sato, Samuel Bruls, Jean Paul Lavigne, Danae Halleux, Rodolphe Durieux, Gregory Hans, Jean Olivier Defraigne, Marc Radermecker.
CHU Liege, Liege, Belgium.
Mitral valve surgery through a right mini-thoracotomy (RMT) is gaining widespread acceptance and has become routine in many centers. Although technically challenging, its potential benefits include a decreased postoperative bleeding and pain, and a faster recovery. We report our early experience of mitral valve surgery through a RMT.
From October 2018 to December 2019, a total of 22 patients underwent a mitral valve surgery through RMT in our center. A complete minimally invasive approach was achieved in all patients. Preoperative diagnostics were mitral valve insufficiency (n=21) with one case of bacterial endocarditis, and rhumatismal mitral valve disease (n=1). Patients were observed during a mean follow-up period of 2 months (Ranging from 1 to 12 months).
The male/female ratio was 15/7. The mean age was 60.8 years (ranging from 36 to 82). There were 8 cases of mitral valve replacement (5 bioprosthesis, and 3 mechanicals), and one case was associated to a tricuspid valve annuloplasty (rhumatismal mitral valve disease). 14 Patients had a mitral valve repair. The mean cross-clamp and by-pass times were respectively 104,2 min (85 min -147 min), and 150,2 min (103 min-239 min). The mean intensive care unit and hospital length of stay were respectively 3 days (1-8), and 10 days (5-31). There were 2 surgical revision at postoperative day (POD) 7 and 8 for bleeding. There was one death (1/22) at POD 6 due to severe bronchopneumonia with septic shock.
Although at the beginning of our minimal invasive mitral valve surgery program with a learning curve period; minimal invasive mitral valve surgery through RMT is a safe and reproducible approach in our center.
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