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International Society For Minimally Invasive Cardiothoracic Surgery

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Bilateral Minithoracotomies For Combined Coronary Bypass Grafting And Mitral Valve Repair
Volodymyr Demianenko, Oleksandr Babliak.
Diagnostic and Treatment Center For Children And Adults Of The Dobrobut Medical Network, Kyiv, Ukraine.

BACKGROUND

Minimally invasive coronary bypass grafting and minimally invasive mitral valve repair have been used independently to manage occlusive coronary artery disease and mitral valve diseases, respectively in our institution. Traditionally, for combined coronary bypass grafting and mitral valve repair the procedure requires median sternotomy. In this study we present combined coronary artery bypass grafting and mitral valve repair via bilateral minithoracotomy.
METHODS

We present 7 patients who underwent combined coronary bypass grafting and mitral valve repair via bilateral minithoracotomies. Cardiopulmonary bypass with peripheral cannulation, Chitwood clamp and intermittent blood cardioplegia were used in all patients. Preoperative and periprocedural parameters were analyzed for all patients.
RESULTS

The minimally invasive mitral valve repair were combined with coronary bypass grafting for single - (n = 3), double - (n = 2), and triple - vessels (n = 2) coronary artery disease in a single operation. The mean number of distal anastomoses was 1.86 0.9 (1; 3) The mean SD duration of cardiopulmonary bypass was 190.3 32.5 (132; 217) minutes and the mean aortic cross-clamp time was 112.9 25.01 (82; 146) minutes. There were no conversions to sternotomy. Patients were discharged 7 1 (5; 8) days.
CONCLUSIONS

Coronary bypass grafting combined with mitral valve repair via bilateral minithoracotomies a safe and feasible strategy, resulting in improved early postoperative outcome with no operative mortalities, conversion or reoperations.


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