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Right mini-thoracotomy approach in patients undergoing redo mitral valve procedure

Indian Journal of Thoracic and Cardiovascular Surgery volume 36, pages 591–597 (2020)Cite this article

Abstract

Aim

A minimally invasive technique is an attractive option in cardiac surgery. In this study, we present our experience with minimally invasive cardiac surgery (MICS) via right mini-thoracotomy on patients undergoing mitral valve procedure as reoperation.

Methods

From 2017 until 2019, 20 patients underwent reoperation of the mitral valve through a right-sided mini-thoracotomy. Cardiopulmonary bypass was established through cannulation of the femoral vessels. All patients requiring isolated re-operative mitral valve surgery with suitable femoral vessels for cannulation were included in the study. Patients requiring concomitant coronary artery bypass grafting (CABG) or with peripheral artery disease were excluded.

Results

The mean age was 65 ± 12 years. The average log. EuroSCORE was 9 ± 5%. Ten patients with severe mitral valve regurgitation (MR) underwent re-repair of the mitral valve. Seven of them were post mitral valve repair (MVR), one was post aortic valve replacement (AVR), one had tricuspid valve repair, and one other patient had CABG before. Ten patients underwent mitral valve replacement due to mixed mitral valve disease (n = 9) or mitral valve endocarditis (n = 1). Eight patients were post MVR and 2 had AVR before. The mean time to reoperation was 7.5 ± 8 years. In-hospital mortality was 5% (n = 1). The mean cross clamp time was 54 ± 26 min. Postoperative echocardiography revealed competent valve function in all cases with mean ejection fraction of 55 ± 9%. The Kaplan-Meier 1- and 2-year survival was 95%.

Conclusion

The MICS approach for mitral valve reoperation in selected patients seems to be safe and feasible. It is also a surgical option for high-risk patients.

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  1. Department of Cardiothoracic Surgery, Helios Heart Center NRW, Siegburg-Wuppertal, University of Witten Herdecke, Witten, Germany

    Nadejda Monsefi, Mahmut Öztürk, Tunjay Shavahatli & Farhad Bakhtiary

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  1. Nadejda Monsefi
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  2. Mahmut Öztürk
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  3. Tunjay Shavahatli
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Correspondence to Nadejda Monsefi.

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This retrospective study complies with the principles of the Declaration of Helsinki and was approved by the institutional ethics committee. All procedures being performed were part of the routine care.

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Monsefi, N., Öztürk, M., Shavahatli, T. et al. Right mini-thoracotomy approach in patients undergoing redo mitral valve procedure. Indian J Thorac Cardiovasc Surg 36, 591–597 (2020). https://doi.org/10.1007/s12055-020-01027-7

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  • DOI: https://doi.org/10.1007/s12055-020-01027-7

Keywords

  • Mitral valve
  • Minimally invasive surgery
  • Video-assisted redo valve procedures