Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients
Abstract 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 patien...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
2020-04-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382020000200185&tlng=en |
| _version_ | 1817988557421150208 |
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| author | Igor Chernov Soslan Enginoev Dmitry Koz’min Gasan Magomedov Dmitry Tarasov Michel Pompeu B. O. Sá Alexander Weymann Konstantin Zhigalov |
| author_facet | Igor Chernov Soslan Enginoev Dmitry Koz’min Gasan Magomedov Dmitry Tarasov Michel Pompeu B. O. Sá Alexander Weymann Konstantin Zhigalov |
| author_sort | Igor Chernov |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-14T00:35:31Z |
| format | Article |
| id | doaj.art-12b829b618ba4386b562534130895cd6 |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-04-14T00:35:31Z |
| publishDate | 2020-04-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-12b829b618ba4386b562534130895cd62022-12-22T02:22:22ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412020-04-0135218519010.21470/1678-9741-2019-0430Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 PatientsIgor ChernovSoslan Enginoevhttps://orcid.org/0000-0002-8376-3104Dmitry Koz’minGasan MagomedovDmitry TarasovMichel Pompeu B. O. SáAlexander WeymannKonstantin ZhigalovAbstract 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382020000200185&tlng=enMitral Valve StenosisMitral Valve-surgeryMini-ThoracotomyCoronary Artery DiseaseMyocardial IschemiaProstheses and ImplantsHospitalizationPostoperative Complications |
| spellingShingle | Igor Chernov Soslan Enginoev Dmitry Koz’min Gasan Magomedov Dmitry Tarasov Michel Pompeu B. O. Sá Alexander Weymann Konstantin Zhigalov Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients Brazilian Journal of Cardiovascular Surgery Mitral Valve Stenosis Mitral Valve-surgery Mini-Thoracotomy Coronary Artery Disease Myocardial Ischemia Prostheses and Implants Hospitalization Postoperative Complications |
| title | Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients |
| title_full | Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients |
| title_fullStr | Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients |
| title_full_unstemmed | Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients |
| title_short | Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients |
| title_sort | minithoracotomy vs conventional mitral valve surgery for rheumatic mitral valve stenosis a single center analysis of 128 patients |
| topic | Mitral Valve Stenosis Mitral Valve-surgery Mini-Thoracotomy Coronary Artery Disease Myocardial Ischemia Prostheses and Implants Hospitalization Postoperative Complications |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382020000200185&tlng=en |
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