TY - JOUR
T1 - Multiple Valve Implantation Through a Minimally Invasive Approach
T2 - Comparison of Standard Median Sternotomy and Right Anterior Thoracotomy
AU - Gumus, Fatih
AU - Hasde, Ali Ihsan
AU - Bermede, Onat
AU - Kilickap, Mustafa
AU - Durdu, Mustafa Serkan
N1 - Publisher Copyright:
© 2020
PY - 2020/9
Y1 - 2020/9
N2 - Background: Following developments in the area of minimally invasive surgery and good, recently published surgical results, the areas in which minimally invasive surgery can be used are beginning to expand. This study aimed to describe experience and show the feasibility and safety of minimally invasive multiple valve implantation with right anterior minithoracotomy (RAT) and compare the outcomes with cases that underwent multiple valve surgery via a standard median sternotomy. Methods: The study cohort comprised 52 patients with combined valvular disease who underwent aortic valve replacement and mitral valve replacement or repair, and/or tricuspid valve ring annuloplasty through median sternotomy (control group n=32) or minimally invasive surgery through a RAT (study group n=20) between January 2012 and December 2018 at the current centre. Preoperative evaluation included coronary catheterisation and multisliced computerised tomography in all patients. Postoperative clinical outcomes and haemodynamic performance of heart valves were reviewed. Results: The mean age of patients was 72.6±7.1 years, and 50% were male. Seventeen (17) patients (32.6%) were in New York Heart Association functional class III or IV. Three (3) patients (7.6%) had third-degree atrioventricular block requiring permanent pacemaker implantation. Mean follow-up was 21±3.9 months (maximum 26 months). No major paravalvular leakage occurred, and there was no postoperative valve migration in either group. Non-valve-related deaths occurred in five patients during follow-up. Conclusion: This study showed that minimally invasive multiple valve implantation is a technically feasible and safe procedure with acceptable surgical outcomes and similar postoperative quality when compared with median sternotomy.
AB - Background: Following developments in the area of minimally invasive surgery and good, recently published surgical results, the areas in which minimally invasive surgery can be used are beginning to expand. This study aimed to describe experience and show the feasibility and safety of minimally invasive multiple valve implantation with right anterior minithoracotomy (RAT) and compare the outcomes with cases that underwent multiple valve surgery via a standard median sternotomy. Methods: The study cohort comprised 52 patients with combined valvular disease who underwent aortic valve replacement and mitral valve replacement or repair, and/or tricuspid valve ring annuloplasty through median sternotomy (control group n=32) or minimally invasive surgery through a RAT (study group n=20) between January 2012 and December 2018 at the current centre. Preoperative evaluation included coronary catheterisation and multisliced computerised tomography in all patients. Postoperative clinical outcomes and haemodynamic performance of heart valves were reviewed. Results: The mean age of patients was 72.6±7.1 years, and 50% were male. Seventeen (17) patients (32.6%) were in New York Heart Association functional class III or IV. Three (3) patients (7.6%) had third-degree atrioventricular block requiring permanent pacemaker implantation. Mean follow-up was 21±3.9 months (maximum 26 months). No major paravalvular leakage occurred, and there was no postoperative valve migration in either group. Non-valve-related deaths occurred in five patients during follow-up. Conclusion: This study showed that minimally invasive multiple valve implantation is a technically feasible and safe procedure with acceptable surgical outcomes and similar postoperative quality when compared with median sternotomy.
KW - Aortic valve replacement
KW - Minimally invasive
KW - Mitral valve replacement
KW - Multiple valve disease
KW - Multiple valve replacement
KW - Valve surgery
UR - http://www.scopus.com/inward/record.url?scp=85082832934&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2020.01.012
DO - 10.1016/j.hlc.2020.01.012
M3 - Article
C2 - 32249168
AN - SCOPUS:85082832934
SN - 1443-9506
VL - 29
SP - 1418
EP - 1423
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 9
ER -