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Objective To compare the results of invasive dual mitral and aortic valve replacement( DVR) through an-terolateral minithoracotomy( RT) and partial upper hemistemotomy( PS) approaches. Methods This was a retrospective, ob-servational, cohort study of collected data on 30 patients undergoing dual mitral and aortic valve replacement between July 2009 and March 2018 at Department of Cardiovascular Surgery, Zhongshan Hospital,Fudan University. There were 10 male and 20 female patients,aging from 15 to 65 years with a mean age of(45. 67 ± 12. 25) years. Of these, 8 were performed through right RT and 22 through PS. SPSS 23. 0 was used to analysis gender, age, left ventricle ejection fraction, New York Heart Associa-tion class, perioperative complications,total operative duration, cardiopulmonary bypass duration, aortic cross clamp time, ICU monitoring time and postoperative hospital stay of the two groups. Results Both groups successfully completed minimally inva-sive double-valve replacement surgery, without middle-opening thoracic surgery. Compared with PS group, patients in the RT grouphadlongeraorticcrossclamptime[(109.00±27.80)minvs.(81.23±14.10)min,P=0.026],cardiopulmonaryby-passduration[(152.13±27.15)minvs.(129.55±26.36)min,P=0.049]andtotaloperativeduration[(4.81±0.77)h vs. (4.15 ±0.44)h, P=0.006]. In addition, the ICU monitoring time and postoperative hospital stay of patients in RT group wereshorterthanPSgroup[(24.63±11.55)hvs.(30.55±13.21)h;(5.50±0.93)dayvs.(6.59±3.88)day] butthere were no statistically significant(P=0. 273;P=0. 442). Conclusion Minimally invasive dual mitral and aortic valve replace-ment via RT and PS are both safe and effective. The incision of RT group is more concealed than the PS group as well as retai-ning sternal integrity. However, the total operative duration, cardiopulmonary bypass duration and aortic cross clamp time were longer than PS group and the requirements of the surgeon are higher. The PS group has a shorter operation time and does not change the habit of the surgeon. It is more suitable for the heart center that proposed to launch the minimally invasive dual mi-tral and aortic valve replacement.
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Objective@#To compare the results of invasive dual mitral and aortic valve replacement(DVR) through anterolateral minithoracotomy(RT) and partial upper hemistemotomy(PS) approaches.@*Methods@#This was a retrospective, observational, cohort study of collected data on 30 patients undergoing dual mitral and aortic valve replacement between July 2009 and March 2018 at Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University. There were 10 male and 20 female patients, aging from 15 to 65 years with a mean age of(45.67±12.25) years. Of these, 8 were performed through right RT and 22 through PS. SPSS 23.0 was used to analysis gender, age, left ventricle ejection fraction, New York Heart Association class, perioperative complications, total operative duration, cardiopulmonary bypass duration, aortic cross clamp time, ICU monitoring time and postoperative hospital stay of the two groups.@*Results@#Both groups successfully completed minimally invasive double-valve replacement surgery, without middle-opening thoracic surgery. Compared with PS group, patients in the RT group had longer aortic cross clamp time[(109.00±27.80)min vs.(81.23±14.10)min, P=0.026], cardiopulmonary bypass duration[(152.13±27.15)min vs.(129.55±26.36)min, P=0.049]and total operative duration[(4.81±0.77)h vs.(4.15±0.44)h, P=0.006]. In addition, the ICU monitoring time and postoperative hospital stay of patients in RT group were shorter than PS group[(24.63±11.55)h vs.(30.55±13.21)h; (5.50±0.93)day vs.(6.59±3.88)day] but there were no statistically significant(P=0.273; P=0.442).@*Conclusion@#Minimally invasive dual mitral and aortic valve replacement via RT and PS are both safe and effective. The incision of RT group is more concealed than the PS group as well as retaining sternal integrity. However, the total operative duration, cardiopulmonary bypass duration and aortic cross clamp time were longer than PS group and the requirements of the surgeon are higher. The PS group has a shorter operation time and does not change the habit of the surgeon. It is more suitable for the heart center that proposed to launch the minimally invasive dual mitral and aortic valve replacement.
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@#Objective To compare right anterolateral minithoracotomy and traditional median sternotomy in the treatment of left atrial myxoma. Methods Forty-one patients with left atrial myxoma treated in our hospital from January 2009 to January 2018 were divided into two groups according to the operation method: a right anterolateral minithoracotomy group including 15 patients, with 7 males and 8 females, aged 45.1±15.4 years; a median sternotomy group including 26 patients, with 10 males and 16 females, aged 49.4±11.9 years. The clinical data of the two groups were compared. Results There was no significant difference in preoperative clinical data between the two groups. All patients completed the operation without perioperative death. There was no significant difference in the operation time, cardiopulmonary bypass time, aortic clamp time or the incidence of postoperative complications between the two groups. However, compared with the median sternotomy group, the right anterolateral minithoracotomy group had shorter duration of mechanical ventilation, ICU stay and postoperative hospital stay, and less volume of drainage and blood transfusion 24 hours after surgery (all P<0.05). After 3–106 months follow-up, no recurrence was observed in both groups. Conclusion Compared with traditional median sternotomy for left atrial myxoma resection, right anterolateral minithoracotomy is safe, effective and less traumatic. It can be used as a routine treatment for left atrial myxoma.