Three-year follow-up after port-access mitral valve surgery.
BACKGROUND
After the promising early results with Port-Access mitral valve (MV) surgery, the mid-term results were evaluated.


METHODS
Among 31 patients receiving this surgery, there were two subgroups (A and B). The 14 patients in group A (7 men, 7 women, 64.0 +/- 12.8 years, LVEF 0.62 +/- 0.118) received the procedure exactly as proposed by Heartport. The 17 patients in group B (6 men, 11 women, 63.0 +/- 11.48 years, LVEF 0.61 +/- 0.117) received a modified technique for a less complex procedure. The underlying diseases were MV insufficiency (n = 14), MV stenosis (n = 9), and combined MV disease (n = 8). One female patient had a partial atrial ventricular canal.


RESULTS
Perioperative mortality was 3.2%. Survival at 39.0 +/- 6.3 months (median +/- SEM) was 93.5%. Two patients required intraoperative inotropic and mechanical support (intra-aortic balloon pump [IABP]). One of these two patients died on postoperative day 3 due to low cardiac output syndrome. All ther patients survived the procedure. Twenty-four patients underwent MV replacement, 7 patients received MV repair, and 1 patient received, in addition, ASD repair. In group B, operative time, ICU stay, and hospitalization was shorter.


CONCLUSIONS
Good early results after Port-Access MV surgery were confirmed by equal mid-term results. The patients are satisfied with the surgical and the cosmetic results, however, Port-Access MV surgery still has to prove superior outcome compared to conventional MV surgery. In selected cases a true reduction of the surgical trauma is possible.
Gulielmos
V
V
Cardiovascular Institute, University of Dresden, Germany. Vassilios.Gulielmos.hkz_dd@t-online.de
Tugtekin
S M
SM
Kappert
U
U
Cichon
R
R
Matschke
K
K
Karbalai
P
P
Schueler
S
S
D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate; D013908:Thoracotomy