The analysis of anterolateral minithoracotomy versus partial upper hemisternotomy in minimally invasive dual mitral and aortic valve replacement
10.3760/cma.j.issn.1001-4497.2019.09.006
- VernacularTitle: 右胸骨旁横切口和胸骨上段切口行微创二尖瓣及主动脉瓣双瓣置换的临床对比研究
- Author:
Ying GUO
1
;
Dian XIONG
2
;
Xianfeng LIU
1
;
Ye YANG
3
;
Shengjia CHENG
1
;
Lai WEI
3
Author Information
1. Department of Cardiothoracic Surgery, Jiujiang First People's Hospital, Jiujiang 332000, China
2. Department of Cardiothoracic Surgery, Shanghai Xuhui District Central Hospital, Shanghai 200031, China
3. Department of Cardiac Surgery, the Affiliated Zhongshan Hospital of Fudan University, Shanghai 200032, China
- Publication Type:Journal Article
- Keywords:
Dual mitral and aortic valve replacement Minimally invasive Anterolateral minithoracotomy Partial upper hemisternotomy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(9):530-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the results of invasive dual mitral and aortic valve replacement(DVR) through anterolateral minithoracotomy(RT) and partial upper hemistemotomy(PS) approaches.
Methods:This was a retrospective, observational, cohort study of collected data on 30 patients undergoing dual mitral and aortic valve replacement between July 2009 and March 2018 at Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University. There were 10 male and 20 female patients, aging from 15 to 65 years with a mean age of(45.67±12.25) years. Of these, 8 were performed through right RT and 22 through PS. SPSS 23.0 was used to analysis gender, age, left ventricle ejection fraction, New York Heart Association class, perioperative complications, total operative duration, cardiopulmonary bypass duration, aortic cross clamp time, ICU monitoring time and postoperative hospital stay of the two groups.
Results:Both groups successfully completed minimally invasive double-valve replacement surgery, without middle-opening thoracic surgery. Compared with PS group, patients in the RT group had longer aortic cross clamp time[(109.00±27.80)min vs.(81.23±14.10)min, P=0.026], cardiopulmonary bypass duration[(152.13±27.15)min vs.(129.55±26.36)min, P=0.049]and total operative duration[(4.81±0.77)h vs.(4.15±0.44)h, P=0.006]. In addition, the ICU monitoring time and postoperative hospital stay of patients in RT group were shorter than PS group[(24.63±11.55)h vs.(30.55±13.21)h; (5.50±0.93)day vs.(6.59±3.88)day] but there were no statistically significant(P=0.273; P=0.442).
Conclusion:Minimally invasive dual mitral and aortic valve replacement via RT and PS are both safe and effective. The incision of RT group is more concealed than the PS group as well as retaining sternal integrity. However, the total operative duration, cardiopulmonary bypass duration and aortic cross clamp time were longer than PS group and the requirements of the surgeon are higher. The PS group has a shorter operation time and does not change the habit of the surgeon. It is more suitable for the heart center that proposed to launch the minimally invasive dual mitral and aortic valve replacement.
