Minimally Invasive Mitral Valve Surgery: Initial One-team Experience and Short Review.

Abstract

Introduction: Minimally invasive mitral valve surgery (MIMVS) is now a widely accepted and more frequently utilized method for patients needing mitral valve surgery. The promoted advantages are less trauma, less bleeding, less pain, and fewer wound infections, allowing faster postoperative and decreased healthcare costs. Material and Methods: This is a single-center retrospective study. We have collected the records of patients who underwent MIMVS by one team at the Cardiac Surgery Service, UHC” Mother Theresa” Hospital. The patients' data regarding demographic, preoperative, operative, and post-operative variables were collected from the medical records in the hospital. All statistical analyses were performed using IBM SPSS version 24.0 software (SPSS, Inc., Chicago, IL, USA). Results: Surgical technique includes mitral valve repair or replacement through right lateral mini-thoracotomy, through a small 5-7cm incision in the 4th–5th right intercostal space under direct vision Seldinger technique under transesophageal echocardiogram guidance is used for cannulation, first 3 cases of MIMVS was performed with 2 venous cannulas – one percutaneous jugular cannula and femoral one, 8 cases underwent single two-stage femoral venous cannulation for venous drainage, femoral arterial cannulation and vacuum assisted cardiopulmonary by-pass(CPB). Conclusion: Minimal-invasive mitral valve surgery is as safe as the standard approach and allows faster recovery with a shorter length of hospitalization, resulting in decreased healthcare costs. We need a more extensive study to confirm the other advantages, but minimal-invasive should be pushed to become a standard approach for mitral valve surgery. An adequate learning curve is mandatory for all the operative teams to achieve all the benefits for the patients.

Keywords

• Mitral valve surgery
• minimally invasive mitral valve procedures
• right lateral Mini thoracotomy