Video-assisted mitral valve reoperation through a right minithoracotomy: A single-center experience

Abstract

Objective: The study aim was to determine our results of minimally invasive technique without aortic cross clamping for mitral valve surgery after previous cardiac surgery.

Material and methods: We performed 24 consecutive mitral valve surgeries between January 2015 and December 2018 in patients with a history of previous cardiac surgery. The procedure was performed using video-assisted right minithoracotomy, femoro-femoral bypass, a temperature of 26 °C, and cardiopulmonary bypass without aortic cross-clamping.

Results: Mitral valve replacement was performed in 12 (50%) of these patients, and mitral valve repair was performed in the same number (50%). The mean ejection fraction was 46.08±6.52% and the mean age was 61.52±11.48 years. Eighteen patients (75%) had previous coronary artery bypass graft surgery, and six patients (25%) had previous mitral valve surgery. In terms of postoperative complication frequencies that patients have experienced, one of the patients (4.1%) had postoperative low cardiac output syndrome. Two patients (8.3%) had renal failure; 2 patients (8.3%) had pneumonia, and stroke was seen in one patient (4.1%) postoperatively, whereas 2 patients (8.3%) had reoperation for bleeding. The mean postoperative packed red blood cell transfusion requirement at 48 hours was 1.00±1.10 units. The mean length of hospital stay was 10.54±4.37 days.

Conclusion: Minimally invasive port access procedure via right thoracotomy may be a safe and effective option in selected patients who need mitral surgery and have a history of prior sternotomy.

Keywords: Reoperation; mitral valve surgery; ventricularfibrillation.