Perioperative outcomes of mitral valvuloplasty via totally thoracoscopic approach versus traditional median sternotomy
- VernacularTitle:全腔镜微创与传统正中开胸二尖瓣成形的围术期临床结果比较
- Author:
Qian YAN
1
,
2
,
3
;
Kan ZHOU
3
,
4
;
Yingjie KE
1
,
5
,
6
,
7
,
8
;
Liang YANG
1
,
2
,
3
;
Zihao LAI
9
;
Yanchen YANG
1
,
2
,
3
;
Huiming GUO
3
,
4
;
Cong LU
3
,
4
;
Huanlei HUANG
3
,
4
Author Information
1. 1. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, P.R.China
2. 2.Department of Cardiovascular Surgery, Guangdong Provincial People'
3. s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Cardiovascular Institute, Guangzhou, 510080, P.R.China
4. Department of Cardiovascular Surgery, Guangdong Provincial People'
5. 3. Department of Cardiovascular Surgery, Guangdong Provincial People'
6. s Hospital'
7. s Nanhai Hospital, The Second People'
8. s Hospital of Nanhai District, Foshan, 528000, Guangdong, P.R.China
9. The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, P.R.China
- Publication Type:Journal Article
- Keywords:
Totally thoracoscopic minimally invasive approach;
median sternotomy;
mitral valvuloplasty;
perioperative outcomes
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(12):1407-1412
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of mitral valvuloplasty via minimally invasive approach with those of mitral valvuloplasty via traditional median sternotomy. Methods A total of 1 221 patients undergoing mitral valvuloplasty from January 2015 to August 2018 in Guangdong Provincial People's Hospital were analyzed retrospectively, including 721 males and 500 females, with an average age of 47.2±15.1 years. According to the different surgical methods, they were divided into a study group (n=654), who received mitral valvuloplasty via the totally thoracoscopic approach, and a control group (n=567), who received mitral valvuloplasty via traditional median sternotomy. Clinical data, surgical results, and perioperative outcomes of the two groups were compared. Results There was no significant difference in preoperative general data between the two groups (P>0.05). Compared with the control group, the study group had longer cardiopulmonary bypass time and aortic cross-clamping time (146.7±42.4 min vs. 122.7±30.6 min, 96.2±32.7 min vs. 78.3±23.8 min, both P=0.000), and shorter total operation time (227.4±55.3 min vs. 238.1±56.4 min, P=0.001). There was no significant difference in the incidence of secondary cross-clamping and mitral valve replacement between the two groups (3.7% vs. 2.6%, P=0.312; 1.7% vs. 1.4%, P=0.690). The blood transfusion rate and the incidence of respiratory tract infection and postoperative poor wound healing were lower (13.0% vs. 24.5%, 2.1%vs. 18.0%, 1.5% vs. 5.3%, all P=0.000) and the postoperative hospital stay was shorter (6.2±4.4 d vs. 11.5±8.8 d, P=0.000) in the study group. There was no significant difference in hospitalization expense between the two groups (95 847.9±31 322.0 yuan vs. 99 673.1±47 930.3 yuan, P=0.149). Within 30 d after surgery, 1 patient died in the study group and 4 patients died in the control group. Before discharge, there were 4 and 5 patients with severe mitral valve regurgitation in the study group and the control group, respectively. Conclusion Compared with mitral valvuloplasty via traditional median sternotomy, minimally invasive mitral valvuloplasty is superior in shortening operation time and postoperative hospital stay, lowering blood transfusion rate, and reducing postoperative complications, which can achieve better clinical outcomes.
