Early outcomes of mitral valvuloplasty by minimally invasive surgery or sternotomy.
BACKGROUND
Disagreement exists regarding methods for repair of the mitral valve. We compared early outcomes of mitral valvuloplasty by a minimally invasive technique and by a median sternotomy.


METHODS
The data of 507 patients (mean age 47.9 ± 15.2 years) undergoing mitral valvuloplasty from January 2015 to June 2018 were analyzed retrospectively. In the study group (n = 225), mitral valvuloplasty via a totally thoracoscopic approach was performed by a single surgeon. In the control group (n = 282), mitral valvuloplasty via the traditional median sternotomy was carried out by other cardiac surgeons in our hospital. Clinical data, surgical results, and follow-up findings in the two groups were comparatively analyzed.


RESULTS
In the study group, the blood transfusion rate (5.3% vs. 20.9%, p < 0.05) and incidences of poor wound healing (0 vs. 5.3%, p < 0.05) and respiratory tract infection (4.4% vs. 16.3%, p < 0.05) were lower, and postoperative hospitalization was shorter (5.9 ± 4.0 vs. 10.7 ± 8.4 days, p < 0.05). Within 30 days after surgery, no patient died in the study group while one died in the control group. The duration of follow-up was 12-36 months (mean 22.9 ± 8.8 months). During follow-up, there were 1 and 0 cases of redo surgery and 1 and 3 deaths in the study group and control group, respectively.


CONCLUSION
Mitral valvuloplasty via a minimally invasive approach is superior to the traditional median sternotomy in terms of early outcomes, especially when performed by experienced surgeons.
['Huang|Huan-Lei|HL|https://orcid.org/0000-0003-0313-7785', 'Yan|Qian|Q|https://orcid.org/0000-0002-4226-7139', 'Xie|Xu-Jing|XJ|', 'Zhou|Kan|K|', 'He|Biao-Chuan|BC|', 'Yang|Liang|L|']
D000328:Adult D006348:Cardiac Surgical Procedures D005260:Female D006439:Hemodynamics D006801:Humans D007902:Length of Stay D008297:Male D008875:Middle Aged D008943:Mitral Valve D008944:Mitral Valve Insufficiency D008945:Mitral Valve Prolapse D011183:Postoperative Complications D020127:Recovery of Function D012086:Reoperation D012189:Retrospective Studies D056346:Sternotomy D013906:Thoracoscopy D013997:Time Factors D016896:Treatment Outcome
mitral valve Cardiac valve annuloplasty minimally invasive surgical procedures thoracoscopy treatment outcome