Early and midterm results of minimally invasive aortic and mitral valve surgery via right mini-thoracotomy.
aortic valve
minimally invasive surgery
mitral valve
right mini-thoracotomy
Journal
Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
pubmed:
7
11
2019
medline:
8
8
2020
entrez:
7
11
2019
Statut:
ppublish
Résumé
There are few reports regarding minimally invasive aortic valve replacement concomitant with mitral valve surgery (MIAMVS). The aim of this study was to evaluate early and midterm MIAMVS results. We reviewed the medical records of 21 consecutive patients (nine females, 43%) who underwent MIAMVS through a right mini-thoracotomy from December 2014 to April 2017. Mean patient age was 73 ± 7.4 years and four (19%) were New York Heart Association Class III or IV. Aortic stenosis and mitral valve insufficiency were the most common pathologies. All patients were followed for a mean period of 30 ± 8.5 months. The types of surgery consisted of aortic valve replacement with mitral valve repair in 11 (52%) patients, and replacement of both aortic and mitral valves in 10 (48%), while a tricuspid valve repair, was performed in four. No conversion to a full sternotomy was necessary in any of the cases. Postoperatively, the median intensive care unit and hospital stays were 4.7 and 11.8 days, respectively, with no in-hospital mortality. Following the initial treatment, all 21 patients were followed for a mean period of 30 ± 8.5 months (14-45 months). All patients returned to NYHA Class I or II following the procedure. During the follow-up period, there was no need for a heart valve reoperation for any of the patients and none showed recurrent mitral regurgitation (>mild), though one died from respiratory failure caused by pneumonia. MIAMVS can be performed via a right mini-thoracotomy, with acceptable early and midterm results expected. This may be a feasible alternative to the standard median sternotomy approach.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-39Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Schmitto JD, Mokashi SA, Cohn LH. Minimally-invasive valve surgery. J Am Coll Cardiol. 2010;56:455-462.
Stolinski J, Plicner D, Grudzien G, et al. A comparison of minimally invasive and standard aortic valve replacement. J Thorac Cardiovasc Surg. 2016;152:1030-1039.
Atik FA, Svensson LG, Blackstone EH, Gillinov AM, Rajeswaran J, Lytle BW. Less invasive versus conventional double-valve surgery: a propensity-matched comparison. J Thorac Cardiovasc Surg. 2011;141:1461-8.e4.
Pfannmüller B, Davierwala P, Hirnle G, et al. Concomitant tricuspid valve repair in patients with minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2013;2:758-764.
Mihos CG, Pineda AM, Davila H, Larrauri-Reyes MC, Santana O. Combined mitral and tricuspid valve surgery performed via a right minithoracotomy approach. Innovations (Phila). 2015;10:304-308.
Shimizu H, Endo S, Natsugoe S, et al. Thoracic and cardiovascular surgery in Japan in 2016 Annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Surg. 2019;67:377-411.
Lamelas J. Minimally invasive concomitant aortic and mitral valve surgery: the ‘Miami Method’. Ann Cardiothorac Surg. 2015;4:33-37.
Lio A, Miceli A, Ferrarini M, Glauber M. Minimally invasive approach for aortic and mitral valve surgery. Eur J Cardiothorac Surg. 2016;50:1204-1205.
Talwar S, Mathur A, Choudhary SK, Singh R, Kumar AS. Aortic valve replacement with mitral valve repair compared with combined aortic and mitral valve replacement. Ann Thorac Surg. 2007;84:1219-1225.