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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg 2022; 70(02): 120-125
DOI: 10.1055/s-0041-1740240
Original Cardiovascular

A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery

Hesham Alkady 
1   Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt
,
Sobhy Abouramadan
1   Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt
› Author Affiliations Funding There are no funders to report for this submission.
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Abstract

Background There is now extension of minimally invasive techniques to involve concomitantly aortic and mitral valves through a single small incision. We share our experience in such surgeries through upper partial sternotomy with approaching the mitral valve through the dome of the left atrium.

Methods Two matched groups of cases receiving concomitant aortic and mitral valve surgeries are compared regarding the surgical outcomes: the minimally invasive group (group A) including 72 patients and the conventional group (group B) including 78 patients.

Results The mean age was 52 ± 8 years in group A and 53 ± 7 years in group B. Males represented (42%) in group A and (49%) in group B. The mean mechanical ventilation time was significantly shorter in group A (4.3 ± 1.2 hours) than in group B (6.1 ± 0.8 hours) with a p-value of 0.001. In addition, the amount of chest tube drainage and the need for blood transfusion units were significantly less in group A (250 ± 160 cm3 and 1.3 ± 0.8 units, respectively) when compared with group B (320 ± 180 cm3 and 1.8 ± 0.9 units, respectively) with p-values of 0.013 and 0.005, respectively. Over a follow-up period of 3.2 ± 1.1 years, one mortality occurred in each group with no significant difference (p-value = 0.512).

Conclusion Combined aortic and mitral valve surgery through upper partial sternotomy with approaching the mitral valve through the dome of the left atrium is safe and effective with the advantages of less postoperative blood loss, need for blood transfusion, and mechanical ventilation time compared with conventional aortic and mitral valve surgery.

Keywords

heart valve surgery - minimally invasive surgery - ministernotomy - sternum - mitral valve surgery - aorta/aortic


Publication History

Received: 25 July 2021

Accepted: 01 September 2021

Article published online:
28 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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