Early and midterm results of minimally invasive aortic and mitral valve surgery via right mini‐thoracotomy

Abstract

Objectives: 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.Methods: 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. Results: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 How to cite this article: Nakayama T, Nakamura Y, Kanamori K, et al. Early and midterm results of minimally invasive aortic and mitral valve surgery via right minithoracotomy.

Decision Making during the Learning Curve of Minimally Invasive Mitral Valve Surgery: A Focused Review for the Starting Minimally Invasive Surgeon

“…Concomitant procedures in MIMVS are usually limited to tricuspid valve surgery, closure of defects in the atrial septum and rhythm surgery. Although concomitant aortic valve surgery [ 29 , 30 ] or coronary artery bypass surgery [ 31 ] are feasible through minimally invasive access, sternotomy remains the most common access for these combined procedures. Chest deformations (e.g., pectus excavatum) or adhesions in the right thorax (e.g., prior pneumothorax or trauma) can limit the view in MIMVS.…”

In-Hospital Outcomes in Minimally Invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

“…Surgery using a minimally invasive technique has proven to be an excellent option for the treatment of atrioventricular valve diseases. Surgeons specifically trained in this approach have achieved excellent results compared to those obtained by the sternotomy technique, but with some advantages over the conventional technique, such as: better pain control, shorter hospital stay, shorter recovery time, less need for transfusion of blood products, smaller perioperative infection rates, less need for imaging and laboratory tests and lower readmission rate in the first postoperative year, better aesthetic result and lower overall cost [1] [3] [4] [5]. It is important to mention that many of these findings are based in observational studies and there is still a lack of randomized controlled trials to confirm these results.…”

Early and mid-term outcomes of minimally invasive mitral valve repair via right mini-thoracotomy: 5-year experience with 129 consecutive patients

“…Minimally invasive mitral valve repair (MIMVr) has been proven to be a feasible alternative to a conventional full sternotomy approach. As compared with conventional surgery, MIMVr has shown excellent early results in terms of morbidity, and providing a shorter hospital stay, and faster recovery and return to normal activities, resulting in reduced use of rehabilitation resources and lower healthcare costs [1][2][3][4][5][6]. On the other hand, disadvantages reportedly include a longer cross-clamp time and technical demands related to performing a valve repair via a small thoracotomy [2,6].…”

“…As compared with conventional surgery, MIMVr has shown excellent early results in terms of morbidity, and providing a shorter hospital stay, and faster recovery and return to normal activities, resulting in reduced use of rehabilitation resources and lower healthcare costs [ 1 – 6 ]. On the other hand, disadvantages reportedly include a longer cross-clamp time and technical demands related to performing a valve repair via a small thoracotomy [ 2 , 6 ]. These disadvantages may affect long term results of MIMVr.…”