Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany.
Ann Cardiothorac Surg. 2013 Nov;2(6):744-50. doi: 10.3978/j.issn.2225-319X.2013.10.14.
Minimally invasive mitral valve surgery has become a routine procedure at our institution. The present study analyzed the early and long-term outcomes of patients undergoing minimally invasive mitral valve surgery over the last decade, with special focus on mitral valve repairs (MVRp).
The preoperative variables, intraoperative data and postoperative outcomes of patients undergoing minimally invasive mitral valve surgery were prospectively collected in our database from May 1999 to December 2010. The survival and freedom from reoperation were evaluated with life tables and Kaplan-Meier analyses.
A total of 3,438 patients underwent minimally invasive mitral valve surgery, of which 2,829 were MVRps and 609 were mitral valve replacements (MVR). Forty-five patients (1.6%) required MVR due to failure of repair. The mean age was 60.3±13 years. More than a third of patients underwent concomitant procedures like tricuspid valve surgery, atrial septal defect (ASD) closure and cryoablation. The rate of conversion to sternotomy was less than 1.4%. The 30-day mortality was 0.8%. The 5- and 10-year survival of all patients (MVR and MVRp) undergoing minimally invasive mitral valve surgery was 85.7±0.6% and 71.5±1.2%, respectively. For MVRp, the survival was 87.0±0.7% and 74.2±1.4% at 5 and 10 years, respectively. Freedom from reoperation was 96.6±0.4% and 92.9±0.9% at 5 and 10 years, respectively.
Minimally invasive MVRp can be performed safely and effectively with very few perioperative complications. The early and long-term outcomes in these patients are acceptable.
微创二尖瓣手术已成为我院的常规手术。本研究分析了过去十年间接受微创二尖瓣手术患者的早期和长期结果，特别关注二尖瓣修复术（MVRp）。
1999 年 5 月至 2010 年 12 月，前瞻性地在我们的数据库中收集了接受微创二尖瓣手术患者的术前变量、术中数据和术后结果。使用寿命表和 Kaplan-Meier 分析评估生存和免于再次手术的情况。
共有 3438 例患者接受了微创二尖瓣手术，其中 2829 例为 MVRp，609 例为二尖瓣置换术（MVR）。45 例（1.6%）因修复失败而需要 MVR。平均年龄为 60.3±13 岁。超过三分之一的患者同时进行了三尖瓣手术、房间隔缺损（ASD）闭合和冷冻消融等手术。转为胸骨切开术的比例不到 1.4%。30 天死亡率为 0.8%。所有接受微创二尖瓣手术的患者（MVR 和 MVRp）的 5 年和 10 年生存率分别为 85.7±0.6%和 71.5±1.2%。对于 MVRp，5 年和 10 年的生存率分别为 87.0±0.7%和 74.2±1.4%。免于再次手术的比例分别为 96.6±0.4%和 92.9±0.9%。
微创 MVRp 可以安全有效地进行，围手术期并发症很少。这些患者的早期和长期结果是可以接受的。
