1 . 2018

Multivalve heart surgery through a mini-access

Abstract

Used in the world since the mid-1990s, minimally invasive valvular surgery has proven to be a real alternative to surgery through the usual full sternotomy. The purpose of this study is to determine the possibilities of minimally invasive surgery based on a retrospective analysis of the direct results of surgical treatment of 30 patients who underwent surgery on two or more heart valves through mini-access. Uncomplicated postoperative period was noted in 19 patients. Two patients died. In one case, the death was caused by acute perioperative myocardial infarction. In the second case – by progressive multiorgan failure. Minimally invasive techniques provide good visualization and the necessary radicalism. With a number of advantages, these operations are promising and can be performed with a high degree of efficiency and safety.

Keywords:minimally invasive heart valve surgery, mini- thoracotomy, partial sternotomy

Clin. Experiment. Surg. Petrovsky J. 2018; 1 (19): 21–6.

DOI: 10.24411/2308-1198-2018-00003

Received: 15.12.2017. Accepted: 25.01.2018.

References

1. Cutler E.C., Levine S.A. Cardiotomy and valvulotomy for mitral stenosis. Boston Med Surg J. 1923; 188: 1023–7.

2. Navia J.L., Cosgrove D.M. Minimally invasive mitral valve operations. Ann Thorac Surg. 1996; 62 (5): 1542–4.

3. Carpentier А., Loulmet D. First open heart operation (mitral valvuloplasty) under videosurgery through a minithoracotomy. Comptes Rendus de l’Academie des Sciences III. 1996; 319 (3): 219– 23.

4. Chitwood W.R.Jr, Wxon C., Elbeery J., et al. Video-assisted minimally invasive mitral valve surgery. J Thorac Cardiovasc Surg. 1997; 114: 773–82.

5. Cohn L.H., Adams D.H., Couper G.S., et al. Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair. Ann Surg. 1997; 226 (4): 421–8.

6. Walther T., Falk V., Metz S., et al. Pain and quality of life after minimally invasive versus conventional cardiac surgery. Ann Thorac Surg. 1999; 67 (6): 1643–7.

7. Schmitto J.D., Mokashi S.A., Cohn L.H. Minimally-invasive valve surgery. J Am Coll Cardiol. 2010; 56 (6): 455–62.

8. Iribarne A., Karpenko A., Russo M., et al. Eight-year experience with minimally invasive cardiothoracic surgery. World J Surg. 2010; 34 (4): 611–5.

9. Chernov I.I, Koz’min D.Yu., Urtaev R.A., et al. The first experience of minimally invasive mitral valve surgery. Klinicheskaya i eksperimental'naya khirurgiya. Zhurnal im. akad. B.V. Petrovskogo [Clin Experiment Surg Petrovsky J]. 2013; 1 (2): 20–3. (in Russian)

10. Cheng D.C.H., Martin J., Lal A., et al. Minimally invasive versus conventional open mitral valve surgery: a meta-analysis and systematic review. Innovations. 2011; 6: 84–103.

11. Chitwood W.R.Jr, Wxon C., Elbeery J., et al. Video-assisted minimally invasive mitral valve surgery. J Thorac Cardiovasc Surg. 1997; 114: 773–82.

12. Greelish J.P., Cohn L.H., Leacche M., et al. Minimally invasive mitral valve repair suggests earlier operations for mitral valve disease. J Thorac Cardiovasc Surg. 2003; 126 (2): 365–73.

13. Gilliov A.M., Banbury M.K., Cosgrove D.M. Hemisternotomy approach for aortic and mitral valve surgery. J Card Surg. 2000; 15 (1): 15–20.

14. Zacharias A., Habib R.H. Factors predisposing to median sternotomy complications: deep versus superficial infection. Chest. 1996; 110 (5): 1173–8.

15. Bryan A.J., Lamarra M., Angelini G.D., et al. Median sternotomy wound dehiscence: a retrospective case control study of risk factors and outcome. J R Coll Surg Edinb. 1992; 37 (5): 305–8.

16. Modi P., Hassan A., Chitwood W.R. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2008; 34 (5): 943–52.