Miceli Antonio, Murzi Michele, Canarutto Daniele, Gilmanov Danyiar, Ferrarini Matteo, Farneti Pier A, Solinas Marco, Glauber Mattia
Fondazione Toscana G. Monasterio, Via Aurelia Sud, Massa, Italy.
Ann Cardiothorac Surg. 2015 Sep;4(5):422-7. doi: 10.3978/j.issn.2225-319X.2015.04.10.
Mitral valve (MV) repair is the gold standard for the treatment of degenerative MV regurgitation. Recently, minimally invasive mitral valve surgery (MIMVS) has shown excellent postoperative outcomes compared with conventional surgery. The aim of our study is to report early and long-term outcomes of patients undergoing MIMVS through right mini-thoracotomy (RT) over an eight year period.
From September 2003 to December 2011, a total of 1,604 consecutive patients underwent MIMVS through RT.
The mean age was 62±13 years, 295 (42%) patients were female and 16 (2.3%) had previous cardiac operations. MV repair was successfully performed in 670 patients, with a rate of success of 95.3%. Repair techniques included annuloplasty (89%), leaflet resection (n=54.2%), neochordae implantation (12.1%), and sliding plasty (10.5%). Overall in-hospital mortality was 0.1%. Incidence of stroke was 1.3%. At eight-year follow-up, overall survival was 90.1%, freedom from reoperation 93%, and freedom from recurrent mitral regurgitation was 90%.
MIMV repair through right minithoracotomy is a safe and reproducible procedure associated with high rate of MV repair, and excellent early postoperative and long-term results.
二尖瓣修复是退行性二尖瓣反流治疗的金标准。近年来，与传统手术相比，微创二尖瓣手术（MIMVS）已显示出优异的术后效果。我们研究的目的是报告八年期间通过右胸小切口（RT）进行MIMVS患者的早期和长期结果。
2003年9月至2011年12月，共有1604例连续患者通过RT进行了MIMVS。
平均年龄为62±13岁，295例（42%）为女性，16例（2.3%）曾接受过心脏手术。670例患者成功进行了二尖瓣修复，成功率为95.3%。修复技术包括瓣环成形术（89%）、瓣叶切除（n = 54.2%）、新腱索植入（12.1%）和滑动成形术（10.5%）。总体住院死亡率为0.1%。中风发生率为1.3%。在八年随访中，总体生存率为90.1%，免于再次手术率为93%，免于二尖瓣反流复发率为90%。
通过右胸小切口进行MIMV修复是一种安全且可重复的手术，二尖瓣修复率高，术后早期和长期效果优异。
