Minimally Invasive Video-assisted Mitral Valve Replacement with a Right Chest Small Incision in Patients Aged Over 65 Years

Abstract

Objective To analyze and summarize the clinical safety and feasibility of minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision in patients aged over 65 years. Methods The clinical data of 45 patients over 65 years old who had mitral valve disease were analyzed retrospectively from January 2014 to January 2017 at Union Hospital, Fujian Medical University. The patients were divided into two groups; 20 patients in group A, who underwent minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision, and 25 patients in group B, who underwent conventional mitral valve replacement. We collected and analyzed their relevant clinical data. Results The operation was completed successfully in both groups. Compared with group B, group A was clearly superior for postoperative analgesia time, postoperative hospital length of stay, thoracic drainage liquid, blood transfusion, and length of incision. There were no differences between the two groups in postoperative severe complications and mortality. More patients in group B had pulmonary infections and poor incision healing, while more patients in group A had postoperative pneumothorax and subcutaneous emphysema. Conclusion In patients aged over 65 years, minimally invasive video-assisted mitral valve replacement with a small incision in the right chest had the same clinical safety and efficacy as the conventional method.

Minimally Invasive Versus Sternotomy for Mitral Surgery in the Elderly: A Systematic Review and Meta-Analysis

“…The studies were relatively recent with the oldest study published in 2011 and the most recent one published in 2019. The smallest study reported on 45 patients 12 and the largest study reported on 340 patients. 16 All of the studies provided a comparison between elderly patients (≥65 years old) undergoing mitral valve surgery through a minimally invasive versus a sternotomy approach.…”

“…There were 10 retrospective observational cohort studies providing a head-to-head comparison between MIMVS and CS in elderly patients (≥65 years old), with a total of 1,897 patients (929 patients in the MIMVS group and 968 patients in the CS group). 4,6,[8][9][10][11][12][13][14][15][16] We had access to the full texts of 7 studies 4,6,[8][9][10][11][12] and only to the abstracts of 3 studies. [13][14][15][16] After reviewing these 3 abstracts along with their accompanying materials, it was believed that we had access to enough information to make an assessment of the quality of the studies and to extract the appropriate information for our systematic review and meta-analysis.…”

“…The proportion of degenerative mitral disease varied among studies, ranging from 60% 6 to 93%. 11 The proportion of mitral repair also varied among studies and ranged from 0% 12 to 100%. 11…”

Minimally Invasive Myxoma Resection: A Single-Center 5 Years’ Experience

“…However, SMR needs to split the sternum in the middle, which destroys the normal bone structure of the sternum and increases the pain experienced by the patient after operation. With the use of wire and bone wax, the risk of foreign body rejection is higher in SMR [Pradeep 2021;Chen 2019]. Additionally, obese patients or patients with diabetes are more prone to incision fat liquefaction or infection, resulting in a prolonged unhealed incision and leaving large scars [Peng 2019;Lv 2019].…”

Periareolar approach in female patients undergoing mitral and tricuspid valve surgery: An almost invisible surgical access

“…Minimally invasive approaches are used in several clinical conditions such as functional mitral insufficiency, 5 endocarditis 6 with successful results. MICS is feasible also for the over‐65s and elderly 7 and for high‐risk patients 8 . In centers used an almost invisible suture line as surgical access is appealing, as well, especially in young women.…”