title: Minimally invasive valve operations.
abstract: BACKGROUND
  To reduce the morbidity from valvular heart operations, a right parasternal approach was introduced. We report our initial experience with the procedure.
  
  
  METHODS
  From January 1996 through July 1996, 115 patients underwent primary isolated valve procedures. One hundred (85%) patients underwent the operation through a right parasternal incision.
  
  
  RESULTS
  There was one hospital death secondary to a stroke on the fifth postoperative day. Three patients (two with aortic valve operations and one having a mitral valve procedure) required conversion to sternotomy. Mean aortic occlusion time was 71 minutes; mean cardiopulmonary bypass time was 93 minutes. Mean stay in the intensive care unit was 27 hours and mean hospital postoperative stay was 5.7 days. Seventy-seven percent of the patients did not receive blood transfusions. Comparison with median sternotomy demonstrated a reduction in both postoperative length of stay and direct hospital costs.
  
  
  CONCLUSIONS
  We conclude that this minimally invasive approach is safe for a variety of valve procedures and is effective in reducing surgical trauma and cost.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Cosgrove
authors.forename: J F
authors.initials: JF
authors.lastname: Sabik
authors.forename: J L
authors.initials: JL
authors.lastname: Navia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass; D002423:Cause of Death; D003422:Critical Care; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery; D009203:Myocardial Infarction / Q000209:etiology; D013249:Sternum / Q000601:surgery; D013908:Thoracotomy / Q000379:methods; D013997:Time Factors