Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients

<i>Background:</i> Minimally invasive mitral valve (MV) surgery has emerged as an alternative to conventional sternotomy aiming to decrease surgical trauma. The aim of the study was to describe our experience with minimally invasive MV surgery through partial upper sternotomy (PUS) regar...

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Autores principales:	Medhat Radwan, Christoph Salewski, Florian Hecker, Aleksandra Miskovic, Petar Risteski, Jan Hlavicka, Anton Moritz, Thomas Walther, Tomas Holubec
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	minimally invasive surgery mitral valve surgery partial upper sternotomy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/607a328fb9f74507924634fe24263f86
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spelling	oai:doaj.org-article:607a328fb9f74507924634fe24263f862021-11-25T18:18:21ZMitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients10.3390/medicina571111791648-91441010-660Xhttps://doaj.org/article/607a328fb9f74507924634fe24263f862021-10-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1179https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background:</i> Minimally invasive mitral valve (MV) surgery has emerged as an alternative to conventional sternotomy aiming to decrease surgical trauma. The aim of the study was to describe our experience with minimally invasive MV surgery through partial upper sternotomy (PUS) regarding short- and long-term outcomes. <i>Methods:</i> From January 2004 through March 2014, 419 patients with a median age of 58.9 years (interquartile range 18.7; 31.7% females) underwent isolated primary MV surgery using PUS. Myxomatous degenerative MV disease was the predominant pathology (77%). The patients’ mean EuroSCORE II risk profile was 3.9 ± 3.6%. <i>Results:</i> Mitral valve repair was performed in 384 patients (91.6%) and replacement in 35 patients (8.4%). Thirty-day mortality was 3.1%. In total, 29 (6.9%) deaths occurred during the follow-up. The overall estimated survival at 1, 5, and 10 years was 93.1 ± 1.3%, 87.1 ± 1.9%, and 81.1 ± 3.4%. Reoperation was necessary in 14 (3.3%) patients. The overall freedom from MV reoperation at 1, 5, and 10 years was 98.2 ± 0.7%, 96.1 ± 1.2%, and 86.7 ± 6.7% and the overall freedom from recurrent MV regurgitation > grade 2 in repaired valves at 1, 5, and 10 years was 98.8 ± 0.6%, 98.8 ± 0.6%, and 94.6 ± 3.3%. <i>Conclusions:</i> Minimally invasive MV surgery via PUS can be performed with particularly good early and late results. Thus, the PUS approach with the use of standard surgical instruments and cannulation techniques can be a valuable option for the MV surgery either in patients contraindicated or not suitable to minithoracotomy.Medhat RadwanChristoph SalewskiFlorian HeckerAleksandra MiskovicPetar RisteskiJan HlavickaAnton MoritzThomas WaltherTomas HolubecMDPI AGarticleminimally invasive surgerymitral valve surgerypartial upper sternotomyMedicine (General)R5-920ENMedicina, Vol 57, Iss 1179, p 1179 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	minimally invasive surgery mitral valve surgery partial upper sternotomy Medicine (General) R5-920
spellingShingle	minimally invasive surgery mitral valve surgery partial upper sternotomy Medicine (General) R5-920 Medhat Radwan Christoph Salewski Florian Hecker Aleksandra Miskovic Petar Risteski Jan Hlavicka Anton Moritz Thomas Walther Tomas Holubec Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients
description	<i>Background:</i> Minimally invasive mitral valve (MV) surgery has emerged as an alternative to conventional sternotomy aiming to decrease surgical trauma. The aim of the study was to describe our experience with minimally invasive MV surgery through partial upper sternotomy (PUS) regarding short- and long-term outcomes. <i>Methods:</i> From January 2004 through March 2014, 419 patients with a median age of 58.9 years (interquartile range 18.7; 31.7% females) underwent isolated primary MV surgery using PUS. Myxomatous degenerative MV disease was the predominant pathology (77%). The patients’ mean EuroSCORE II risk profile was 3.9 ± 3.6%. <i>Results:</i> Mitral valve repair was performed in 384 patients (91.6%) and replacement in 35 patients (8.4%). Thirty-day mortality was 3.1%. In total, 29 (6.9%) deaths occurred during the follow-up. The overall estimated survival at 1, 5, and 10 years was 93.1 ± 1.3%, 87.1 ± 1.9%, and 81.1 ± 3.4%. Reoperation was necessary in 14 (3.3%) patients. The overall freedom from MV reoperation at 1, 5, and 10 years was 98.2 ± 0.7%, 96.1 ± 1.2%, and 86.7 ± 6.7% and the overall freedom from recurrent MV regurgitation > grade 2 in repaired valves at 1, 5, and 10 years was 98.8 ± 0.6%, 98.8 ± 0.6%, and 94.6 ± 3.3%. <i>Conclusions:</i> Minimally invasive MV surgery via PUS can be performed with particularly good early and late results. Thus, the PUS approach with the use of standard surgical instruments and cannulation techniques can be a valuable option for the MV surgery either in patients contraindicated or not suitable to minithoracotomy.
format	article
author	Medhat Radwan Christoph Salewski Florian Hecker Aleksandra Miskovic Petar Risteski Jan Hlavicka Anton Moritz Thomas Walther Tomas Holubec
author_facet	Medhat Radwan Christoph Salewski Florian Hecker Aleksandra Miskovic Petar Risteski Jan Hlavicka Anton Moritz Thomas Walther Tomas Holubec
author_sort	Medhat Radwan
title	Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients
title_short	Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients
title_full	Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients
title_fullStr	Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients
title_full_unstemmed	Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients
title_sort	mitral valve surgery via upper ministernotomy: single-centre experience in more than 400 patients
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/607a328fb9f74507924634fe24263f86
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Mitral Valve Surgery via Upper Ministernotomy: Single-Centre Experience in More than 400 Patients

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