Endoscopic Non-rib Spreading Mitral Valve Surgery Early Results And Experience After 300 Patients
Rafik Margaryan, Giacomo Bianchi, Marco Solinas.
Ospedale Del Cuore Fondazione 'G. Monasterio', Massa, Italy.
Objectives: Non-rib-spreading fully endoscopic mitral valve surger is gaining atention worldwidly. We report our early 5 year results for endoscpoic mitral vavlve surgery.
Methods: A retrospectively collected data of 320 consecutive patients having received an endoscopic mitral valve procedure between July 2015 and Dec 2019. For all patients, access was made through a 3-4 cm incision in the inframammary fold (ladies), periareolar cut (males) or axillary appropach (in both sexes) through the third or fourth intercostal space. Only a soft-tissue retractor, and no additional rib-spreader, was used. Operative visualization was provided by 2D and 3D endoscopy.
Results: Mitral procedure was successful in all patients without technical repair limitations. Mortality was 0% at 30 days of follow-up. Mean age was 62.2 ± 11.9 years old. Mean CBP and aortic XC time were 144.4 ± 30.7 and 92.0 ± 22.9 minutes, mean procedural time was 238.0 ± 93.7 minutes. Mean hospital stay was 7.4 ± 3.7. Repair rate on degenerative mitral valve disease was 278 (95%).
Conclusions: Mitral endoscopic procedure is safe and reproducable approace for single valve mitral surgery, contributing an excellent quality of repair results. Video guiadance is helpful tool especially for complex reconstruction cases and exact placement of artificial neochordae. Population of patients benefit from shorter hospitalization with reduced postoperative pain and early mobilization.
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