Pojar Marek, Vojacek Jan, Karalko Mikita, Turek Zdenek
Department of Cardiac Surgery, Charles University, Faculty of Medicine and University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic.
Department of Anesthesiology, Resuscitation and Intensive Medicine, Charles University, Faculty of Medicine and University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic.
Ann Thorac Cardiovasc Surg. 2019 Feb 20;25(1):18-25. doi: 10.5761/atcs.oa.18-00100. Epub 2018 Sep 20.
To report single-institution experience with minimally invasive mitral valve operations through the right minithoracotomy over a 5-year period.
Patients who underwent minimally invasive mitral valve surgery (MIMVS) between January 2012 and December 2016 were included. Clinical follow-up data were collected in a prospective database and analyzed retrospectively.
Data from 151 patients were assessed (mean age, 63.4 ± 9.7 years; 55% were females). Overall 30-day mortality was 0.7% (n = 1). Mean operating time, cardiopulmonary bypass, and aortic cross-clamp times were 254.9 ± 48.7, 140.5 ± 36.1, and 94.8 ± 27.0 minutes, respectively. Associated procedures were tricuspid valve annuloplasty (37.1%, n = 56) and closure of atrial septal defect (6.0%, n = 9). Cryoablation was performed in 43.7% of patients (n = 66). One patient (0.7%) required conversion to median sternotomy and six patients (4.0%) underwent re-explorations due to bleeding. Median postoperative hospital stay was 12 days. Overall survival at 5 years was 94.1% ± 2.0%. Freedom from reoperation was 94.6% ± 2.9% at 5 years.
MIMVS is a feasible, safe, and reproducible approach with low mortality and morbidity. Mitral valve surgery through a small thoracotomy is a good alternative to conventional surgical access.
报告单机构在5年期间通过右胸小切口进行微创二尖瓣手术的经验。
纳入2012年1月至2016年12月期间接受微创二尖瓣手术（MIMVS）的患者。临床随访数据收集于前瞻性数据库并进行回顾性分析。
评估了151例患者的数据（平均年龄63.4±9.7岁；55%为女性）。总体30天死亡率为0.7%（n = 1）。平均手术时间、体外循环时间和主动脉阻断时间分别为254.9±48.7、140.5±36.1和94.8±27.0分钟。相关手术包括三尖瓣环成形术（37.1%，n = 56）和房间隔缺损闭合术（6.0%，n = 9）。43.7%的患者（n = 66）进行了冷冻消融。1例患者（0.7%）需要转为正中开胸，6例患者（4.0%）因出血进行了再次手术探查。术后中位住院时间为12天。5年总体生存率为94.1%±2.0%。5年再次手术率为94.6%±2.9%。
MIMVS是一种可行、安全且可重复的方法，死亡率和发病率低。通过小切口进行二尖瓣手术是传统手术入路的良好替代方法。
