Title |
Mitral valve surgery using video-assisted right minithoracotomy and deep hypothermic perfusion in patients with previous cardiac operations
|
---|---|
Published in |
Journal of Cardiothoracic Surgery, April 2015
|
DOI | 10.1186/s13019-015-0259-0 |
Pubmed ID | |
Authors |
H Tarık Kızıltan, Aslı İdem, Salih Salihi, Ali Soner Demir, Aşkın Ali Korkmaz, Mustafa Güden |
Abstract |
Redo-sternotomy for mitral valve (MV) surgery may be complex and attendant complications can be avoided using anterolateral right thoracotomy, deep hypothermia (20°C, nasopharyngeal) with low flow cardiopulmonary perfusion. Video-assisted minithoracotomy technique is a further improvement. We performed 20 consecutive MV operations in patients with previous cardiac surgery using video-assisted right minithoracotomy, femoro-femoral bypass, deep hypothermia, low flow cardiopulmonary bypass without aortic cross-clamping. The mean follow-up was 30 ± 17.8 mo. Data is presented as the mean ± standard deviation of the mean. There were 11 males and 9 females (age, 62.3 ± 12.1; ejection fraction 50.1 ± 11.2). Operations included MV replacement (n = 11), MV repair (n = 5), and MV re-replacement (n = 4). There were no hospital deaths, and the mean hospital stay was 8 ± 2.9 days. There were no postoperative strokes or need for mechanical circulatory support. The mean cardiopulmonary bypass time was 152 ± 28 minutes. All patients were free from inotropic support at 48 hours. Two patients (10%) required inotropic support beyond 24 hrs. All patients were free from inotropic support at 48 hours. The mean number of transfused red cell units was 2.8 ± 0.8 (range, 2 to 4). One patient died in another institution six months postoperatively following surgery for acute type III aortic dissection. At 30 ± 17.8 months follow-up all patients were found to be in NYHA Class I or II. Minimally invasive video-assisted MV surgery using deep hypothermia, low-flow cardiopulmonary bypass without aortic clamping can result in excellent clinical outcomes in patients with previous cardiac surgery via a median sternotomy. This technique offers reproducible results, good myocardial protection (as evidenced by the low rate of inotropic support that patients needed postoperatively), and low rates of complications. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 6% |
Unknown | 17 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 5 | 28% |
Student > Master | 4 | 22% |
Student > Bachelor | 3 | 17% |
Student > Ph. D. Student | 1 | 6% |
Student > Doctoral Student | 1 | 6% |
Other | 2 | 11% |
Unknown | 2 | 11% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 9 | 50% |
Veterinary Science and Veterinary Medicine | 1 | 6% |
Physics and Astronomy | 1 | 6% |
Nursing and Health Professions | 1 | 6% |
Materials Science | 1 | 6% |
Other | 1 | 6% |
Unknown | 4 | 22% |