Single-Center Experience with Minimally Invasive Mitral Operations through Right Minithoracotomy
Language English Country Japan Media print-electronic
Document type Journal Article
PubMed
30232298
PubMed Central
PMC6388298
DOI
10.5761/atcs.oa.18-00100
Knihovny.cz E-resources
- Keywords
- endoscopic surgery, minimally invasive, minithoracotomy, mitral valve, mitral valve repair,
- MeSH
- Mitral Valve Annuloplasty * adverse effects mortality MeSH
- Time Factors MeSH
- Heart Valve Prosthesis Implantation * adverse effects mortality MeSH
- Databases, Factual MeSH
- Echocardiography MeSH
- Middle Aged MeSH
- Humans MeSH
- Mitral Valve diagnostic imaging physiopathology surgery MeSH
- Mitral Valve Insufficiency diagnostic imaging mortality physiopathology surgery MeSH
- Postoperative Complications etiology surgery MeSH
- Reoperation MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Feasibility Studies MeSH
- Thoracotomy adverse effects methods mortality MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: To report single-institution experience with minimally invasive mitral valve operations through the right minithoracotomy over a 5-year period. METHODS: Patients who underwent minimally invasive mitral valve surgery (MIMVS) between January 2012 and December 2016 were included. Clinical follow-up data were collected in a prospective database and analyzed retrospectively. RESULTS: Data from 151 patients were assessed (mean age, 63.4 ± 9.7 years; 55% were females). Overall 30-day mortality was 0.7% (n = 1). Mean operating time, cardiopulmonary bypass, and aortic cross-clamp times were 254.9 ± 48.7, 140.5 ± 36.1, and 94.8 ± 27.0 minutes, respectively. Associated procedures were tricuspid valve annuloplasty (37.1%, n = 56) and closure of atrial septal defect (6.0%, n = 9). Cryoablation was performed in 43.7% of patients (n = 66). One patient (0.7%) required conversion to median sternotomy and six patients (4.0%) underwent re-explorations due to bleeding. Median postoperative hospital stay was 12 days. Overall survival at 5 years was 94.1% ± 2.0%. Freedom from reoperation was 94.6% ± 2.9% at 5 years. CONCLUSIONS: MIMVS is a feasible, safe, and reproducible approach with low mortality and morbidity. Mitral valve surgery through a small thoracotomy is a good alternative to conventional surgical access.
See more in PubMed
Aybek T, Dogan S, Risteski PS, et al. Two hundred forty minimally invasive mitral operations through right minithoracotomy. Ann Thorac Surg 2006; 81: 1618-24. PubMed
Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Eur J Cardiothorac Surg 2012; 42: S1-44. PubMed
Calkins H, Hindricks G, Cappato R, et al. HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary. J Arrhythm 2017; 33: 369-409. PubMed PMC
Glauber M, Miceli A, Canarutto D, et al. Early and long-term outcomes of minimally invasive mitral valve surgery through right minithoracotomy: a 10-year experience in 1604 patients. J Cardiothorac Surg 2015; 10: 181. PubMed PMC
Gammie JS, Sheng S, Griffith BP, et al. Trends in mitral valve surgery in the United States: results from the Society of thoracic surgeons adult cardiac surgery database. Ann Thorac Surg 2009; 87: 1431-7; discussion 1437-9. PubMed
Perier P, Stumpf J, Götz C, et al. Valve repair for mitral regurgitation caused by isolated prolapse of the posterior leaflet. Ann Thorac Surg 1997; 64: 445-50. PubMed
Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg 2006; 82: 819-26. PubMed
Seeburger J, Borger MA, Falk V, et al. Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients. Eur J Cardiothorac Surg 2008; 34: 760-5. PubMed
Cheng DC, Martin J, Lal A, et al. Minimally invasive versus conventional open mitral valve surgery: a meta-analysis and systematic review. Innovations (Phila) 2011; 6: 84-103. PubMed
Falk V, Cheng DC, Martin J, et al. Minimally invasive versus open mitral valve surgery: a consensus statement of the international society of minimally invasive coronary surgery (ISMICS) 2010. Innovations (Phila). 2011; 6: 66-76. PubMed
Mohty D, Orszulak TA, Schaff HV, et al. Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation 2001; 104: I1-7. PubMed
Perier P, Hohenberger W, Lakew F, et al. Minimally invasive repair of posterior leaflet mitral valve prolapse with the “respect” approach. Ann Cardiothorac Surg 2013; 2: 833-8. PubMed PMC
Holubec T, Sündermann SH, Jacobs S, et al. Chordae replacement versus leaflet resection in minimally invasive mitral valve repair. Ann Cardiothorac Surg 2013; 2: 809-13. PubMed PMC
Davierwala PM, Seeburger J, Pfannmueller B, et al. Minimally invasive mitral valve surgery: “the Leipzig experience”. Ann Cardiothorac Surg 2013; 2: 744-50. PubMed PMC
Al Yamani MI, Frapier JM, Battistella PD, et al. Right coronary cusp perforation after mitral valve replacement. Interact Cardiovasc Thorac Surg 2013; 16: 387-8. PubMed PMC
Svensson LG, Atik FA, Cosgrove DM, et al. Minimally invasive versus conventional mitral valve surgery: a propensity-matched comparison. J Thorac Cardiovasc Surg 2010; 139: 926-32.e1-2. PubMed
Holzhey DM, Shi W, Borger MA, et al. Minimally invasive versus sternotomy approach for mitral valve surgery in patients greater than 70 years old: a propensity-matched comparison. Ann Thorac Surg 2011; 91: 401-5. PubMed
Lange R, Voss B, Kehl V, et al. Right minithoracotomy versus full sternotomy for mitral valve repair: a propensity matched comparison. Ann Thorac Surg 2017; 103: 573-9. PubMed
Santana O, Reyna J, Benjo AM, et al. Outcomes of minimally invasive valve surgery in patients with chronic obstructive pulmonary disease. Eur J Cardiothorac Surg 2012; 42: 648-52. PubMed
Santana O, Reyna J, Grana R, et al. Outcomes of minimally invasive valve surgery versus standard sternotomy in obese patients undergoing isolated valve surgery. Ann Thorac Surg 2011; 91: 406-10. PubMed
Vollroth M, Seeburger J, Garbade J, et al. Minimally invasive mitral valve surgery is a very safe procedure with very low rates of conversion to full sternotomy. Eur J Cardiothorac Surg 2012; 42: e13-15; discusson e16. PubMed
Seeburger J, Borger MA, Falk V, et al. Minimally invasive mitral valve surgery after previous sternotomy: experience in 181 patients. Ann Thorac Surg 2009; 87: 709-14. PubMed
Casselman FP, La Meir M, Jeanmart H, et al. Endoscopic mitral and tricuspid valve surgery after previous cardiac surgery. Circulation 2007; 116: I270-5. PubMed
Santana O, Krishna R, Kherada N, et al. Outcomes of minimally invasive valve surgery in patients with multiple previous cardiac operations. J Heart Valve Dis 2016; 25: 487-90. PubMed