Document Detail


Minimally invasive mitral valve surgery through right thoracotomy in patients with patent coronary artery bypass grafts.
MedLine Citation:
PMID:  19329506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report our institutional experience, with 25 consecutive patients with patent coronary artery bypass grafts (71.8+/-12.7 years), who underwent video-assisted minithoracotomic approach for mitral valve surgery. The surgical technique includes: right minithoracotomy, femoral cannulation and hypothermic ventricular fibrillation. Mean preoperative EuroSCORE was 10.2+/-2.4 and mean ejection fraction was 45+/-9%. Operative mortality was 4% (1/25). No patient required a conversion to sternotomy. Procedures performed were: mitral valve repair in 15 patients (60%), replacement in 10 (40%) and associated tricuspid repair in seven (28%). Mean blood transfusion was 1.2 package/patient. No cardiological, neurological, vascular and wound complications were observed. Postoperative major morbidity includes: severe pulmonary dysfunction in two patients (8%) and acute renal failure in one (4%). Mean ICU and hospital stay were 3.4+/-2.9 and 10.6+/-7.9 days. Echocardiographic follow-up (22.8+/-14.9 months) revealed trace or mild mitral valve regurgitation in all the mitral repair patients. When interrogated, all the surviving patients preferred the minithoracotomic approach rather than the sternotomy. In conclusion, minimally invasive right thoracotomy can be safely performed in patients with functioning coronary bypass grafts requiring mitral valve operation. Low blood transfusion, the avoidance of deep wound infection and the high patient satisfaction are the main advantages of this approach.
Authors:
Michele Murzi; Enkel Kallushi; Kaushal K Tiwari; Alfredo G Cerillo; Stefano Bevilacqua; Jamshid H Karimov; Marco Solinas; Mattia Glauber
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Publication Detail:
Type:  Journal Article     Date:  2009-03-27
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-23     Completed Date:  2009-08-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  29-32     Citation Subset:  IM    
Affiliation:
Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, IFC-CNR, Via Aurelia Sud 54100, Massa, Italy. michelem@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Transfusion
Cardiac Surgical Procedures* / adverse effects
Coronary Artery Bypass*
Feasibility Studies
Female
Heart Valve Diseases / surgery*,  ultrasonography
Humans
Intensive Care
Kidney Failure, Acute / etiology
Length of Stay
Lung Diseases / etiology
Male
Middle Aged
Mitral Valve / surgery*,  ultrasonography
Patient Satisfaction
Thoracic Surgery, Video-Assisted* / adverse effects
Thoracotomy* / adverse effects
Time Factors
Treatment Outcome
Tricuspid Valve / surgery,  ultrasonography

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


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