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Outcomes of Right Minithoracotomy Mitral Valve Surgery in Patients With Previous Sternotomy.
MedLine Citation:
PMID:  21513916     Owner:  NLM     Status:  Publisher    
BACKGROUND: We evaluated the outcomes of patients with a history of previous sternotomy who underwent minimally invasive mitral valve surgery through a right minithoracotomy approach. METHODS: We reviewed all the isolated mitral valve operations performed at our institution between January 1, 2005, and October 8, 2010, and selected for analysis only patients who had had a prior sternotomy. The outcome of patients who underwent a minimally invasive approach was compared with that of patients whose mitral surgery was performed through a standard median sternotomy. RESULTS: There were 88 patients with prior sternotomy, with 59 having minimally invasive surgery and 29 undergoing a repeat median sternotomy. Significant baseline differences (minimally invasive versus sternotomy, respectively) included the number of male patients (76% versus 45%, p = 0.003), prior coronary artery bypass graft surgery (71% versus 45%, p = 0.02), prior valve surgery (47% versus 72%, p = 0.03), congestive heart failure (46% versus 76%, p = 0.008), and diabetes mellitus (34% versus 10%, p = 0.02). The in-hospital mortality and composite postoperative complications were 3% versus 14% (p = 0.07) and 29% versus 66% (p = 0.001) for the minimally invasive versus the median sternotomy group, respectively. The intensive care unit stay and hospital length of stay were 48 hours (interquartile range [IQR], 41 to 90) versus 118 hours (IQR, 67 to 167; p < 0.001), and 8 days (IQR, 6 to 12) versus 13 days (IQR, 9 to 18; p = 0.001), for the minimally invasive and median sternotomy groups, respectively. CONCLUSIONS: Minimally invasive mitral valve surgery in patients who have had a prior sternotomy is associated with improved postoperative outcomes and reduced resource utilization, when compared with a median sternotomy approach.
Christos G Mihos; Orlando Santana; Gervasio A Lamas; Joseph Lamelas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-20
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida.
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