“A Prospective Randomized Case-Control Study To Evaluate Mini Right Thoracotomy versus Conventional Sternotomy For Mitral Valve Repair In Rheumatic Heart Disease.”

Abstract

Purpose: Right mini thoracotomy has been evaluated in many studies for mitral valve repair mainly in degenerative valvular disease but not in rheumatic heart disease. Mitral valve repair is more challenging in rheumatic etiology due to complexity of lesions. This prospective randomized case control study was designed to evaluate repair through mini right thoracotomy and to compare the clinical and echocardiographic outcomes with sternotomy in rheumatic patients. Methods: 25 patients of rheumatic heart disease underwent mitral valve repair through mini right thoracotomy (group I). Various clinical and functional parameters were compared with 25 patients of mitral valve repair through sternotomy (group II). On follow up the results were compared in both groups for clinical and echocardiographic parameters. Results: The various pre-operative demographic parameters were comparable in two groups. Equal rate of mitral valve repair (group I-21/25, 84% and group II-21/25, 84%) was achieved in both groups. The various intra-operative and post-operative clinical parameters were better in group I .There were equivalent functional and valve related outcomes in both groups in term of NYHA class (1.28 ± 0.613 vs 1.08 ± 0.276, P = 0.144), post-operative mitral valve area (2.43 ± 0.891 vs 2.82 ± 0.662, P = 0.090), incidence of more than mild mitral regurgitation (0) and mean pressure gradient across mitral valve (4.98 ± 3.33 vs 4.23 ± 1.5, P = 0.309). Conclusion: Mitral valve repair through mini right thoracotomy approach in rheumatic etiology is feasible and safe with equivalent rate of successful repair as compared to median ster-How to cite this paper: Chahal, A.K., et al.

Minithoracotomy vs. Conventional Mitral Valve Surgery for Rheumatic Mitral Valve Stenosis: a Single-Center Analysis of 128 Patients

“…There is still a lack of evidence regarding the use of the minimally invasive techniques for RMS. Chahal et al [16] published one randomized case-control study comparing right-sided minithoracotomy with sternotomy in patients with rheumatic MV lesions, during which it was shown that the minithoracotomy group had shorter ventilation time, hospitalization, and time…”

Evaluating Short-Term Postoperative Outcomes in Minimally Invasive Mitral Valve Surgery for Patients with Rheumatic Disease

“…effect, shorter period of hospitalization, and reduce trauma, while maintaining the safety and effectiveness compared with median sternotomy [Chernov 2020;Chahal 2016]. Anh et al reported on 142 patients with rheumatic mitral valve dysfunction who underwent MIMVS at the University Medical Center of Ho Chi Minh City in Vietnam.…”