Minimal Invasive Thoracoscopic Mitral Valve Surgery

Abstract

Introduction The totally thoracoscopic approach for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure’s feasibility, safety and effectiveness when it was performed by an experienced operator. Methods We retrospectively analysed 96 consecutive patients with MV disease treated between March 2016 and November 2019 by minimally invasive procedures. The procedures were performed on a femoral artery-vein bypass through two ports, including a main operation port and a thoracoscopic port. The clinical data of patients were collected, including preoperative cardiac function, operative data, postoperative complications, and follow-up. Results A total of 96 patients (57 male patients; average age, 49.7±14.5 years; left ventricular ejection fraction, 65.6±7.7%) were enrolled in this study. No intraoperative conversion incision or death occurred. The cardiopulmonary bypass and aortic cross-clamp times were 163.8±50.6 minutes and 119.7±38.9 minutes, respectively. Postoperative chest tube drainage in the first 24 hours was 232.8±108.1 ml. The ventilation time and length of intensive care unit stay were 13.2±6.2 hours and 2.9±2.2 days, respectively. One patient died of disseminated intravascular coagulation and prosthesis thrombosis 3 days after the operation, fearing anticoagulant-related hemorrhage. The overall success rate of valve repair during 1-year follow-up was 97.9%. Conclusion The totally thoracoscopic procedure on mitral valves by an experienced surgeon is technically feasible, safe, effective and worthy of widespread adoption in clinical practice.

The anesthesia management of totally thoracoscopic cardiac surgery: A single-center retrospective study

“…Since the introduction of minimally invasive cardiac surgery (MICS) in 1990s [ 6 , 7 ], as a main MICS procedure, TTCS has become the current trend in cardiac surgery [ 8 , 9 ]. In our center, TTCS has been used for MVR/MVA, TVR/TVA, resection of atrial myxoma, repair of atrial septal or ventricular septal defects, and radiofrequency ablation of atrial fibrillation.…”