Comparing Conscious Sedation With Regional Anesthesia Versus General Anesthesia in Minimally Invasive Mitral Valve Surgery With Right-Sided Minithoracotomy: A Retrospective Study.

OBJECTIVES

The aims of the present study were to evaluate and compare the safety and feasibility, including hospitalization, intensive care unit (ICU) stay, frequency of conversion to general anesthesia (GA), pH, PaCO, and PaO, of selected patients who underwent minimally invasive mitral valve surgery (MIMVS) via a right minithoracotomy under conscious sedation (CS) to avoid GA. The authors also aimed to evaluate the perioperative management of spontaneous breathing.

DESIGN

A retrospective, observational study.

SETTING

Single-center.

PARTICIPANTS

This study enrolled 101 patients who underwent MIMVS under CS or GA.

INTERVENTIONS

The patients who underwent MIMVS were managed under CS or GA according to indication criteria.

MEASUREMENTS AND MAIN RESULTS

ICU stay (p = 0.010), postoperative time until first fluid intake (p < 0.0001), and duration of mechanical ventilation (p = 0.004) were shorter in the CS group than in the GA group. No patients converted to GA from CS. PaCO during cardiopulmonary bypass (CPB) in the CS group was significantly lower than that in the GA group. However, PaCO at the termination of CPB in the CS group was significantly higher than that in the GA group.

CONCLUSIONS

In the CS group, advanced-age patients with comorbidities underwent mitral surgery without postoperative complications. The authors' findings suggested that MIMVS under CS could be a potentially less-invasive method, providing a quicker recovery than MIMVS under GA.