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Minimally invasive mitral valve surgery through right anterolateral thoracotomy—review and personal experience

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Abstract

Since the mid-1950s, after the invention of the heart-lung machine, mitral valve surgery is being done routinely by many surgeons. Even though the first multivalvular surgery was done through right thoracotomy, median sternotomy has become the approach of choice for a long time. In the last two decades, minimally invasive mitral valve surgery (MIMVS) has picked up with the presumption of less tissue injury, faster patient recovery, and more patient satisfaction. In spite of improvements in technology, surgical techniques, and cannulation methods, many surgeons have concerns about the efficacy of mitral surgery done under limited exposure, learning curve involved, and potentially prolonged operative times. In this article, we reviewed the literature on MIMVS through right thoracotomy and our personal experience.

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References

  1. Ritwick B, Chaudhuri K, Crouch G, Edwards JR, Worthington M, Stuklis RG. Minimally invasive mitral valve procedures: the current state. Minim Invasive Surg. 2013;2013:679276.

    PubMed  PubMed Central  Google Scholar 

  2. Chitwood WR, Elbeery JR, Chapman WH, et al. Video-assisted minimally invasive mitral valve surgery: “micro-mitral” operation. J Thorac Cardiovasc Surg. 1997;113:413–4.

    Article  PubMed  Google Scholar 

  3. Falk V, Walther T, Autschbach R, Diegeler A, Battellini R, Mohr FW. Robot-assisted minimally invasive solo mitral valve operation. J Thorac Cardiovasc Surg. 1998;115:470–1.

    Article  PubMed  CAS  Google Scholar 

  4. Davierwala PM, Seeburger J, Pfannmueller B, et al. Minimally invasive mitral valve surgery: “the Leipzig experience”. Ann Cardiothorac Surg. 2013;2:744–50.

    PubMed  PubMed Central  Google Scholar 

  5. Loulmet DF, Carpentier A, Cho PW, et al. Less invasive techniques for mitral valve surgery. J Thorac Cardiovasc Surg. 1998;115:772–9.

    Article  PubMed  CAS  Google Scholar 

  6. Wolfe JA, Malaisrie SC, Farivar RS, et al. Minimally invasive mitral valve surgery II: surgical technique and postoperative management. Innovations. 2016;11:251–9.

    PubMed  PubMed Central  Google Scholar 

  7. Felger JE, Nifong LW, Chitwood WR Jr. The evolution of and early experience with robot-assisted mitral valve surgery. Surgl Laparosc Endosc Percutan Tech. 2002;12:58–63.

    Article  Google Scholar 

  8. Modi P, Hassan A, Chitwood WR Jr. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2008;34:943–52.

    Article  PubMed  Google Scholar 

  9. Rosengart TK, Feldman T, Borger MA, et al. Percutaneous and minimally invasive valve procedure: a scientificstatement from the American Heart Association Council on Cardiovascular surgery and anaesthesia, council on clinical cardiology, functional genomics and translational biology interdisciplinary working group, and quality of care and outcomes research interdisciplinary working group. Circulation. 2008;117:1750–67.

    Article  PubMed  Google Scholar 

  10. Youssef SJ, Millan JA, Youssef GM, Earnheart A, Lehr EJ, Barnhart GR. Therole of computed tomography angiography in patients undergoing evaluationfor minimally invasive cardiac surgery: an early program experience. Innovations. 2015;10:33–8.

    PubMed  Google Scholar 

  11. Ailawadi G, Agnihotri AK, Mehall JR, et al. Minimally invasive mitral valve surgery I: patient selection, evaluation, and planning. Innovations. 2016;11:243–50.

    PubMed  PubMed Central  Google Scholar 

  12. Holzhey DM, Shi W, Borger MA, et al. Minimally nvasiveversus sternotomyapproach for mitral valve surgery in patients greater than 70 years old: apropensity-matched comparison. Ann Thorac Surg. 2011;91:401–5.

    Article  PubMed  Google Scholar 

  13. Botta L, Cannata A, Bruschi G, et al. Minimally invasive approach for redo mitral valve surgery. J Thorac Dis. 2013;5:S686–93.

    PubMed  PubMed Central  Google Scholar 

  14. Murzi M, Miceli A, Stefano GD, et al. Minimally invasive right thoracotomy approach for mitral valve surgery in patients with previous sternotomy: a single institution experience with 173 patients. J Thorac Cardiovasc Surg. 2014;148:2763–8.

    Article  PubMed  Google Scholar 

  15. Braxton JH, Higgins RS, Schwann TA, et al. Reoperative mitral valve surgery via right thoracotomy: decreased blood loss and improved haemodynamics. J Heart Valve Dis. 1996;5:169–73.

    PubMed  CAS  Google Scholar 

  16. Romano MA, Haft JW, Pagani FD, Bolling SF. Beating heart surgery via right thoracotomy for reoperative mitral valve surgery: a safe and effective operative alternative. J Thorac Cardiovasc Surg. 2012;144:334–9.

    Article  PubMed  Google Scholar 

  17. Murzi M, Kallushi E, Tiwari KK, et al. Minimally invasive mitral valve surgery through right thoracotomy in patients with patent coronary artery bypass grafts. Interact Cardiovasc Thorac Surg. 2009;9:29–32.

    Article  PubMed  Google Scholar 

  18. Seeburger J, Borger. Minimally invasive mitral valve surgery after previous sternotomy: experience in 181 patients. Ann Thorac Surg. 2009;87:709–14.

    Article  PubMed  Google Scholar 

  19. Arcidi JM Jr, Rodriguez E, Elbeery JR, Nifong LW, Efird JT, Chitwood WR Jr. Fifteen-year experience with minimally invasive approach for reoperations involving the mitral valve. J Thorac Cardiovasc Surg. 2012;143:1062–8.

    Article  PubMed  Google Scholar 

  20. Sharony R, Grossi EA, Saunders PC, et al. Minimally invasive reoperative isolated valve surgery: early and mid-term results. J Card Surg. 2006;21:240–4.

    Article  PubMed  Google Scholar 

  21. Casselman FP, Van Slycke S, Wellens F, et al. Mitral valve surgery can now routinely be performed endoscopically. Circulation. 2003;108:II48–54.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Holzhey DM, Seeburger J, Misfeld M, Borger MA, Mohr FW. Learning minimally invasive mitral valve surgery: a cumulative sum sequential probability analysis of 3895 operations from a single high-volume center. Circulation. 2013;128:483–91.

    Article  PubMed  Google Scholar 

  24. Misfeld M, Borger M, Byrne JG, et al. Cross-sectional survey on minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2013;2:733–8.

    PubMed  PubMed Central  Google Scholar 

  25. Schmitto JD, Mokashi SA, Cohn LH. Minimally-invasive valve surgery. J Am Coll Cardiol. 2010;56:455–62.

    Article  PubMed  Google Scholar 

  26. Wolfe JA, Malaisrie SC, Farivar RS, et al. Minimally invasive mitral valve surgery II: surgical technique and postoperative management. Innovations. 2016;11:251–9.

    PubMed  PubMed Central  Google Scholar 

  27. Carpentier A, Loulmet D, Carpentier A, et al. Open heartoperation under video surgeryand minithoracotomy. First case(mitral valvuloplasty) operated with success. CRAcadSciIII. 1996;319:219–23.

    CAS  Google Scholar 

  28. Sorabella RA, Michael Argenziano M. Minimally invasive mitral valve repair through a right minithoracotomy approach. Ann Cardiothorac Surg. 2015;4:478–9.

    PubMed  PubMed Central  Google Scholar 

  29. Grossi EA, Loulmet DF, Schwartz CF, et al. Minimally invasive valve surgery with antegrade perfusion strategy is not associated with increased neurologic complications. Ann Thorac Surg. 2011;92:1346–9.

    Article  PubMed  Google Scholar 

  30. Gammie JS, Zhao Y, Peterson ED, O'Brien SM, Rankin JS, Griffith BP. Less-invasive mitral valve operations: trends and outcomes from the Society of Thoracic Surgeons adult cardiac surgery database. Ann Thorac Surg. 2010;90:1401–10.

    Article  PubMed  Google Scholar 

  31. Goldstone AB, Atluri P, Szeto WY, et al. Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: a propensity-matched comparison. J Thorac Cardiovasc Surg. 2013;145:748–56.

    Article  PubMed  PubMed Central  Google Scholar 

  32. McClure RS, Athanasopoulos LV, McGurk S, Davidson MJ, Couper GS, Cohn LH. Onethousand minimally invasive mitral valve operations: earlyoutcomes, late outcomes, and echocardiographic follow-up. J Thorac Cardiovasc Surg. 2013;145:1199–206.

    Article  PubMed  Google Scholar 

  33. Mohr FW, Falk V, Diegeler A, Walther T, van Son JA, Autschbach R. Minimally invasive port-access mitral valve surgery. J Thorac Cardiovasc Surg. 1998;115:567–76.

    Article  PubMed  CAS  Google Scholar 

  34. Grossi EA, Galloway AC, Ribakove GH, et al. Impact of minimally invasive valvular heart surgery: a case-control study. Ann Thorac Surg. 2001;71:807–10.

    Article  PubMed  CAS  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. Sundermann SH, Sromicki J, Rodriguez Cetina Biefer H, et al. Mitral valve surgery: right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2014;148:1989–95.

    Article  PubMed  Google Scholar 

  37. Grossi EA, Loulmet DF, Schwartz CF, et al. Evolution of operative techniques and perfusion strategies for minimally invasive mitral valve repair. J Thorac CardiovascSurg. 2012;143:S68–70.

    Article  Google Scholar 

  38. Iribarne A, Easterwood R, Russo MJ, Chan EY, Smith CR, Argenziano M. Comparative effectiveness of minimally invasive versus traditional sternotomy mitral valve surgery in elderly patients. J Thorac Cardiovasc Surg. 2012;143:S86–90.

    Article  PubMed  Google Scholar 

  39. Falk V, Cheng DCH, 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. 2011;2:66–76.

    Google Scholar 

  40. Galloway AC, Schwartz CF, Ribakove GH, et al. A decade of minimally invasive mitral repair: long-term outcomes. Ann Thorac Surg. 2009;88:1180–4.

    Article  PubMed  Google Scholar 

  41. Cheng DC, Martin J, Lal A, et al. Minimally invasive versus conventionalopen mitral valve surgery: a meta-analysis and systematic review. Innovations (Phila). 2011;6:84–103.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiothoracic and transplant surgery, Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, India

    Gopala Krishna Gokhale Alla, Yamini Alla & Siddharth Reddy Chinta

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  1. Gopala Krishna Gokhale Alla
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  2. Yamini Alla
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  3. Siddharth Reddy Chinta
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Correspondence to Gopala Krishna Gokhale Alla.

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This article does not contain any studies with human participants or animals performed by any of the authors. This is only a retrospective analysis.

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Papers selected for this article were identified through “Google search” using the terms “mitral valve surgery through right thoracotomy.” All selected articles were reviewed and references were selected on the basis of number of patients and contributions in the field.

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Alla, G.K.G., Alla, Y. & Chinta, S.R. Minimally invasive mitral valve surgery through right anterolateral thoracotomy—review and personal experience. Indian J Thorac Cardiovasc Surg 34 (Suppl 2), 117–123 (2018). https://doi.org/10.1007/s12055-018-0644-0

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  • DOI: https://doi.org/10.1007/s12055-018-0644-0

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