Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis : a Single-Center Analysis of 128 Patients
OBJECTIVE: To compare the in-hospital outcomes of a right-sided anterolateral minithoracotomy with those of median sternotomy in patients who received a mitral valve replacement (MVR) because of rheumatic mitral valve stenosis (RMS).
METHODS: This is a retrospective analysis of 128 patients (34% male) with RMS between 2011 and 2015. The median age was 53 years (45; 56). The mean ejection fraction was 58.4±6.3%. All the subjects were divided into two groups - Group 1 contained 78 patients who underwent MVR via minithoracotomy (MT-MVR), while Group 2 contained 50 patients who underwent MVR via median sternotomy (S-MVR).
RESULTS: In the MT-MVR group, a mechanical prosthesis was implanted in 72% of cases, while it was implanted in 90% of cases in the S-MVR group (P=0.01). The duration of myocardial ischemia was similar (MT-MVR, 77±24 min; S-MVR, 70±18 min) (P=0.09). However, the cardiopulmonary bypass time was lower in the S-MVR group than in the MT-MVR group (99±24 min and 119±34 min, respectively) (P≤0.001). There was no difference in the duration of mechanical ventilation, intensive care unit stay, and hospitalization period. Postoperative blood loss was lower in the MT-MVR group (P≤0.001) than in the S-MVR group. There are no statistically significant differences in postoperative complications (superficial wound infection, stroke, delirium, pericardial tamponade, pleural puncture, acute kidney insufficiency, and implantation of pacemaker). The overall in-hospital mortality was 3.9% (P=0.6).
CONCLUSION: The minimally invasive approach for RMS is feasible and has an excellent cosmetic effect without increasing the risk of surgical complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Brazilian journal of cardiovascular surgery - 35(2020), 2 vom: 01. Apr., Seite 185-190 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chernov, Igor [VerfasserIn] |
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| Links: |
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| Themen: |
Coronary Artery Disease |
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| Anmerkungen: |
Date Completed 13.10.2020 Date Revised 13.10.2020 published: Electronic Citation Status MEDLINE |
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| doi: |
10.21470/1678-9741-2019-0430 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM309528038 |
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| 041 | |a eng | ||
| 100 | 1 | |a Chernov, Igor |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis |b a Single-Center Analysis of 128 Patients |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 13.10.2020 | ||
| 500 | |a Date Revised 13.10.2020 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To compare the in-hospital outcomes of a right-sided anterolateral minithoracotomy with those of median sternotomy in patients who received a mitral valve replacement (MVR) because of rheumatic mitral valve stenosis (RMS) | ||
| 520 | |a METHODS: This is a retrospective analysis of 128 patients (34% male) with RMS between 2011 and 2015. The median age was 53 years (45; 56). The mean ejection fraction was 58.4±6.3%. All the subjects were divided into two groups - Group 1 contained 78 patients who underwent MVR via minithoracotomy (MT-MVR), while Group 2 contained 50 patients who underwent MVR via median sternotomy (S-MVR) | ||
| 520 | |a RESULTS: In the MT-MVR group, a mechanical prosthesis was implanted in 72% of cases, while it was implanted in 90% of cases in the S-MVR group (P=0.01). The duration of myocardial ischemia was similar (MT-MVR, 77±24 min; S-MVR, 70±18 min) (P=0.09). However, the cardiopulmonary bypass time was lower in the S-MVR group than in the MT-MVR group (99±24 min and 119±34 min, respectively) (P≤0.001). There was no difference in the duration of mechanical ventilation, intensive care unit stay, and hospitalization period. Postoperative blood loss was lower in the MT-MVR group (P≤0.001) than in the S-MVR group. There are no statistically significant differences in postoperative complications (superficial wound infection, stroke, delirium, pericardial tamponade, pleural puncture, acute kidney insufficiency, and implantation of pacemaker). The overall in-hospital mortality was 3.9% (P=0.6) | ||
| 520 | |a CONCLUSION: The minimally invasive approach for RMS is feasible and has an excellent cosmetic effect without increasing the risk of surgical complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronary Artery Disease | |
| 650 | 4 | |a Hospitalization | |
| 650 | 4 | |a Mini-Thoracotomy | |
| 650 | 4 | |a Mitral Valve Stenosis | |
| 650 | 4 | |a Mitral Valve-surgery | |
| 650 | 4 | |a Myocardial Ischemia | |
| 650 | 4 | |a Postoperative Complications | |
| 650 | 4 | |a Prostheses and Implants | |
| 700 | 1 | |a Enginoev, Soslan |e verfasserin |4 aut | |
| 700 | 1 | |a Koz'min, Dmitry |e verfasserin |4 aut | |
| 700 | 1 | |a Magomedov, Gasan |e verfasserin |4 aut | |
| 700 | 1 | |a Tarasov, Dmitry |e verfasserin |4 aut | |
| 700 | 1 | |a Sá, Michel Pompeu B O |e verfasserin |4 aut | |
| 700 | 1 | |a Weymann, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Zhigalov, Konstantin |e verfasserin |4 aut | |
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