Document Detail


Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients.
MedLine Citation:
PMID:  18586512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Some have expressed concern that minimal invasive mitral valve (MV) repair may not meet the standard of open surgical techniques. We therefore reviewed our results for minimal invasive MV repair for mitral regurgitation (MR). MATERIAL AND METHODS: Between March 1999 and February 2007, a total of 1536 consecutive patients underwent minimal invasive MV surgery for MR at our institution using a right lateral mini-thoracotomy and femoral cannulation for cardiopulmonary bypass. Of these, a total of 1339 (87.2%) patients underwent MV repair and these form the focus of this study. The mean grade of preoperative MR was 3.3+/-0.6, age was 60.3+/-12.7 years, ejection fraction was 59.2+/-15.1% and 819 patients (61.2%) were male. RESULTS: The procedure was successfully performed in all but four patients (0.3%) who required intraoperative conversion to full sternotomy. MV repair techniques consisted of ring annuloplasty with or without chordae-replacement or Carpentier-type leaflet resection. Concomitant procedures consisted of atrial fibrillation ablation in 351 patients (26.2%), tricuspid valve surgery in 80 patients (6.0%), and patent foramen ovale/atrial septal defect closure in 88 patients (6.6%). Mean duration of CPB was 121+/-38min and mean aortic cross-clamp time was 70+/-32min. Thirty-day mortality was 2.4%. Follow-up was performed in 99% of patients at an average of 28.1+/-23.9 months postoperatively. The Kaplan-Meier estimate for survival at 5 years was 82.6% (95% CI: 78.9-85.7%) and for freedom from MV reoperation was 96.3% (95% CI: 94.6-97.4%). CONCLUSIONS: Minimal invasive MV repair, along with certain concomitant procedures, can be performed in the vast majority of patients with MR. Our large series demonstrates that these procedures can be performed with low perioperative complication rates and very good durability.
Authors:
Joerg Seeburger; Michael Andrew Borger; Volkmar Falk; Thomas Kuntze; Markus Czesla; Thomas Walther; Nicolas Doll; Friedrich Wilhelm Mohr
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-06-30
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  34     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-17     Completed Date:  2009-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  760-5     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Heartcenter, Leipzig University, Struempelstrasse 39, 04289 Leipzig, Germany. j.seeburger@web.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Bypass / methods
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Mitral Valve / surgery*
Mitral Valve Insufficiency / physiopathology,  surgery*
Reoperation
Surgical Procedures, Minimally Invasive / methods
Thoracotomy / methods
Treatment Outcome
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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