Operative Outcomes of Concomitant Minimally Invasive Mitral and Tricuspid Valve Surgery.
OBJECTIVE
The aim of this study was to evaluate whether the addition of concomitant tricuspid valve surgery (TVS) negatively impacted operative outcomes of minimally invasive mitral valve surgery (MIMVS).


METHODS
Patients undergoing MIMVS via a port-access right minithoracotomy between 2002 and 2014 at a single institution were reviewed. Patients were primarily stratified by those undergoing isolated MIMVS versus MIMVS+TVS. Propensity-matched cohorts were generated. Operative outcomes were compared between the propensity-matched cohorts and included operative mortality, complications, and length of hospital stay.


RESULTS
A total of 1,158 patients underwent MIMVS via port-access right minithoracotomy. The majority of cases were elective (93%; n = 1,071) and 148 (13%) underwent concomitant MIMVS + TVS. Patients undergoing MIMVS + TVS were at higher risk at baseline. After propensity-matching, there were 119 isolated MIMVS and 119 MIMVS + TVS patients that were well matched with respect to all baseline variables. Cardiopulmonary bypass (148 ± 54 minutes versus 175 ± 54 minutes, P < 0.001) and aortic occlusion times (105 ± 36 minutes versus 128 ± 40 minutes, P < 0.001) were longer in the MIMVS + TVS group. Operative mortality was comparable (3% isolated MIMVS versus 4% for MIMVS + TVS; P = 0.73). Permanent pacemakers were required less frequently in the isolated MIMVS group (1% versus 6%; P = 0.03). All other complication rates were similar. Median length of hospital stay (7 versus 8 days; P = 0.13) and discharge-to-home rates (89% versus 94%; P = 0.15) were comparable.


CONCLUSIONS
Despite longer operative times, minimally invasive TVS performed concomitantly with MIMVS has similar operative outcomes with the exception of a higher pacemaker rate when compared with isolated MIMVS.
['Kilic|Arman|A|', 'Szeto|Wilson Y|WY|', 'Atluri|Pavan|P|', 'Acker|Michael A|MA|', 'Clark Hargrove|W|W|']
D000368:Aged D058385:Cardiac Valve Annuloplasty D016022:Case-Control Studies D005260:Female D006801:Humans D008297:Male D019060:Minimally Invasive Surgical Procedures D008943:Mitral Valve D008944:Mitral Valve Insufficiency D012189:Retrospective Studies D016896:Treatment Outcome D014261:Tricuspid Valve D014262:Tricuspid Valve Insufficiency
outcomes tricuspid valve mitral valve minimally invasive surgery stroke