Early results of minimally invasive mitral valve surgery: initial series in a public hospital in Australia.
OBJECTIVE
This study analyzes the initial experience with minimally invasive mitral valve surgery through a right minithoracotomy in a public teaching hospital in Australia and evaluates early surgical outcomes.


METHODS
A retrospective review of patients who underwent minimally invasive mitral valve surgery between November 2006 and March 2009 was performed.


RESULTS
A total of 60 patients included 47 (78%) patients who had mitral valve plasty and 13 (22%) who had mitral valve replacement. The mean age was 61 ± 15 years; 33 (55%) patients were male; and 6 (10%) had had previous cardiac operations. The mean cardiopulmonary bypass and aortic cross-clamp times were 140 ± 46 and 93 ± 35 min, respectively. All patients who underwent mitral valve plasty left the operation room with no more than trivial residual mitral regurgitation. There was no operative mortality. Reoperation for bleeding and stroke occurred in 2 patients each. The mean intensive care unit and hospital stays were 3.1 ± 5.8 and 10.6 ± 8.9 days, respectively. Among the 47 patients with mitral valve plasty, 46 (98%) had mild or less mitral regurgitation on transthoracic echocardiography at discharge. There was one late death. No reoperation for the mitral valve has been observed so far. An echocardiography report was obtained for 34 of the 47 who had had mitral valve plasty at 12.1 ± 7.9 months postoperatively, and 27 (79%) of them had mild or less mitral regurgitation.


CONCLUSIONS
Minimally invasive mitral valve surgery through a right minithoracotomy was safely performed with no early mortality.
Cardiothoracic Surgical Unit, Royal Adelaide Hospital, Adelaide, Australia. funcorogash@hotmail.com
Tadashi
T
Kitamura
James
J
Edwards
Michael
M
Worthington
Kaushalendra S
KS
Rathore
Manoranjan
M
Misra
E K
EK
Slimani
G V
GV
Ramana Kumar
John
J
Stubberfield
Robert G
RG
Stuklis
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002315:Cardiopulmonary Bypass; D003422:Critical Care; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013021:South Australia; D013908:Thoracotomy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography