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Early results of minimally invasive mitral valve surgery: initial series in a public hospital in Australia

General Thoracic and Cardiovascular Surgery volume 58, pages 568–572 (2010)Cite this article

Abstract

Purpose

This study analyzes the initial experience with minimally invasive mitral valve surgery through a right minithoracotomy in a public teaching hospital in Australia and evaluates early surgical outcomes.

Methods

A retrospective review of patients who underwent minimally invasive mitral valve surgery between November 2006 and March 2009 was performed.

Results

A total of 60 patients included 47 (78%) patients who had mitral valve plasty and 13 (22%) who had mitral valve replacement. The mean age was 61 ± 15 years; 33 (55%) patients were male; and 6 (10%) had had previous cardiac operations. The mean cardiopulmonary bypass and aortic cross-clamp times were 140 ± 46 and 93 ± 35 min, respectively. All patients who underwent mitral valve plasty left the operation room with no more than trivial residual mitral regurgitation. There was no operative mortality. Reoperation for bleeding and stroke occurred in 2 patients each. The mean intensive care unit and hospital stays were 3.1 ± 5.8 and 10.6 ± 8.9 days, respectively. Among the 47 patients with mitral valve plasty, 46 (98%) had mild or less mitral regurgitation on transthoracic echocardiography at discharge. There was one late death. No reoperation for the mitral valve has been observed so far. An echocardiography report was obtained for 34 of the 47 who had had mitral valve plasty at 12.1 ± 7.9 months postoperatively, and 27 (79%) of them had mild or less mitral regurgitation.

Conclusion

Minimally invasive mitral valve surgery through a right minithoracotomy was safely performed with no early mortality.

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References

  1. McClure RS, Cohn LH, Wiegerinck E, Couper GS, Aranki SF, Bolman RM 3rd, et al. Early and late outcomes in minimally invasive mitral valve repair: an eleven-year experience in 707 patients. J Thorac Cardiovasc Surg 2009;137:70–75.

    Article  PubMed  Google Scholar 

  2. Modi P, Rodriguez E, Hargrove WC 3rd, Hassan A, Szeto WY, Chitwood WR Jr. Minimally invasive video-assisted mitral valve surgery: a 12-year, 2-center experience in 1178 patients. J Thorac Cardiovasc Surg 2009;137:1481–1487.

    Article  PubMed  Google Scholar 

  3. Seeburger J, Borger MA, Falk V, Kuntze T, Czesla M, Walther T, et al. Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients. Eur J Cardiothorac Surg 2008;34:760–765.

    Article  PubMed  Google Scholar 

  4. Modi P, Hassan A, Chitwood WR Jr. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg 2008;34:943–952.

    Article  PubMed  Google Scholar 

  5. 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;115:567–574; discussion 574–6.

    CAS  Article  PubMed  Google Scholar 

  6. Gammie JS, Sheng S, Griffith BP, Peterson ED, Rankin JS, O’Brien SM, 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;87:1431–1437; discussion 1437–9.

    Article  PubMed  Google Scholar 

  7. Suri RM, Schaff HV, Dearani JA, Sundt TM 3rd, Daly RC, Mullany CJ, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg 2006;82:819–826.

    Article  PubMed  Google Scholar 

  8. Gillinov AM, Blackstone EH, Nowicki ER, Slisatkorn W, Al-Dossari G, Johnston DR, et al. Valve repair versus valve replacement for degenerative mitral valve disease. J Thorac Cardiovasc Surg 2008;135:885–893, 893.e 1–2.

    Article  PubMed  Google Scholar 

  9. Ailawadi G, Swenson BR, Girotti ME, Gazoni LM, Peeler BB, Kern JA, et al. Is mitral valve repair superior to replacement in elderly patients? Ann Thorac Surg 2008;86:77–85; discussion 86.

    Article  PubMed  Google Scholar 

  10. Gillinov AM, Blackstone EH, Alaulaqi A, Sabik JF 3rd, Mihaljevic T, Svensson LG, et al. Outcomes after repair of the anterior mitral leaflet for degenerative disease. Ann Thorac Surg 2008;86:708–717; discussion 708–17.

    Article  PubMed  Google Scholar 

  11. Carpentier A. Cardiac valve surgery—the “French correction.” J Thorac Cardiovasc Surg 1983;86:323–337.

    CAS  PubMed  Google Scholar 

  12. Von Oppell UO, Mohr FW. Chordal replacement for both minimally invasive and conventional mitral valve surgery using premeasured Gore-Tex loops. Ann Thorac Surg 2000;70:2166–2168.

    Article  Google Scholar 

  13. Lapenna E, De Bonis M, Sorrentino F, La Canna G, Grimaldi A, Torracca L, et al. Commissural closure for the treatment of commissural mitral valve prolapse or flail. J Heart Valve Dis 2008;17:261–266.

    PubMed  Google Scholar 

  14. Falk V, Seeburger J, Czesla M, Borger MA, Willige J, Kuntze T, et al. How does the use of polytetrafluoroethylene neochordae for posterior mitral valve prolapse (loop technique) compare with leaflet resection? A prospective randomized trial. J Thorac Cardiovasc Surg 2008;136:1205; discussion 1205–6.

    Article  PubMed  Google Scholar 

  15. Gammie JS, Zhao Y, Rankin JS, O’Brien S, Griffith BP. Utilization and outcomes of less invasive mitral valve operations in North America. Presented at the 46th annual meeting of the Society of Thoracic Surgeons.

  16. Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, et al. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Valvular Heart Disease). Circulation 2008;118:e523–e661.

    Article  PubMed  Google Scholar 

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Affiliations

  1. Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, Australia

    Tadashi Kitamura, James Edwards, Michael Worthington, Kaushalendra S. Rathore, Manoranjan Misra, E. K. Slimani, G. V. Ramana Kumar, John Stubberfield & Robert G. Stuklis

  2. Department of Cardiothoracic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan

    Tadashi Kitamura

Authors
  1. Tadashi Kitamura
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  2. James Edwards
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  3. Michael Worthington
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  4. Kaushalendra S. Rathore
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  5. Manoranjan Misra
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  6. E. K. Slimani
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  7. G. V. Ramana Kumar
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  8. John Stubberfield
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  9. Robert G. Stuklis
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Correspondence to Tadashi Kitamura.

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Kitamura, T., Edwards, J., Worthington, M. et al. Early results of minimally invasive mitral valve surgery: initial series in a public hospital in Australia. Gen Thorac Cardiovasc Surg 58, 568–572 (2010). https://doi.org/10.1007/s11748-010-0649-0

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  • DOI: https://doi.org/10.1007/s11748-010-0649-0

Key words

  • Minimally invasive surgery
  • Mitral valve
  • Outcomes