Minithoracotomy vs. conventional mitral valve surgery for rheumatic mitral valve stenosis: a single-center analysis of 128 patients
Rev. bras. cir. cardiovasc
;
35(2): 185-190, 2020. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1101468
ABSTRACT
Abstract Objective:
To compare the in-hospital outcomes of a right-sided anterolateral minithoracotomy with those of median sternotomy in patients who received a mitral valve replacement (MVR) because of rheumatic mitral valve stenosis (RMS).Methods:
This is a retrospective analysis of 128 patients (34% male) with RMS between 2011 and 2015. The median age was 53 years (45; 56). The mean ejection fraction was 58.4±6.3%. All the subjects were divided into two groups - Group 1 contained 78 patients who underwent MVR via minithoracotomy (MT-MVR), while Group 2 contained 50 patients who underwent MVR via median sternotomy (S-MVR).Results:
In the MT-MVR group, a mechanical prosthesis was implanted in 72% of cases, while it was implanted in 90% of cases in the S-MVR group (P=0.01). The duration of myocardial ischemia was similar (MT-MVR, 77±24 min; S-MVR, 70±18 min) (P=0.09). However, the cardiopulmonary bypass time was lower in the S-MVR group than in the MT-MVR group (99±24 min and 119±34 min, respectively) (P≤0.001). There was no difference in the duration of mechanical ventilation, intensive care unit stay, and hospitalization period. Postoperative blood loss was lower in the MT-MVR group (P≤0.001) than in the S-MVR group. There are no statistically significant differences in postoperative complications (superficial wound infection, stroke, delirium, pericardial tamponade, pleural puncture, acute kidney insufficiency, and implantation of pacemaker). The overall in-hospital mortality was 3.9% (P=0.6)Conclusion:
The minimally invasive approach for RMS is feasible and has an excellent cosmetic effect without increasing the risk of surgical complications.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Implante de Prótese de Valva Cardíaca
/
Estenose da Valva Mitral
Tipo de estudo:
Estudo observacional
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
Cirurgia Geral
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Alemanha
/
Federação Russa
Instituição/País de afiliação:
Federal Center for Cardiovascular Surgery/RU
/
Pronto Socorro Cardiológico de Pernambuco - PROCAPE/BR
/
University Duisburg-Essen/DE
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