Cargando…

Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure

BACKGROUND: The totally thoracoscopic procedure for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure’s feasibility, safety and effectiveness when it was performed by an experienced operator. METHODS: We retrospectively analysed 53 consecutive patients with MV d...

Descripción completa

Detalles Bibliográficos
Autores principales: Jiang, Qin, Yu, Tao, Huang, Keli, Liu, Lihua, Zhang, Xiaoshen, Hu, Shengshou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310972/
https://www.ncbi.nlm.nih.gov/pubmed/30594225
http://dx.doi.org/10.1186/s13019-018-0819-1
_version_ 1783383524622991360
author Jiang, Qin
Yu, Tao
Huang, Keli
Liu, Lihua
Zhang, Xiaoshen
Hu, Shengshou
author_facet Jiang, Qin
Yu, Tao
Huang, Keli
Liu, Lihua
Zhang, Xiaoshen
Hu, Shengshou
author_sort Jiang, Qin
collection PubMed
description BACKGROUND: The totally thoracoscopic procedure for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure’s feasibility, safety and effectiveness when it was performed by an experienced operator. METHODS: We retrospectively analysed 53 consecutive patients with MV disease treated between December 2014 and April 2017 by minimally invasive procedures. The procedures were performed on femoral artery-vein bypass through three 2–4 cm incisions, with one additional penetrating point on the right chest wall under totally thoracoscopic visual guidance and surveillance of transoesophageal echocardiography. RESULTS: Two patients who underwent intraoperative conversion to sternotomy were excluded due to indivisible pleural cavity adhesion. Of the others (38 female patients, average age, 49 ± 14 years, left ventricular ejection fraction, 59 ± 7%), 34 received MV replacement for rheumatic mitral lesions, which was redone for one patient after the discovery of serious paravalvular leakage, 17 received MV repair for mitral regurgitation (with 4 secondary to atrial septum defect, 2 diagnosed with left atrial myxoma, and 2 redone for mitral valve replacement due to repair failure), 28 received additional tricuspid valvuloplasty, and one patient received a Warden procedure. The cardiopulmonary bypass and aortic cross clamp times were 144 ± 39 min and 80 ± 22 min, respectively. Postoperational chest tube drainage in the first 48 h was 346 ± 316 ml. The ventilation time and intensive care unit stay length were 11 ± 11 h and 23 ± 2 h, respectively. One patient died of disseminated intravascular coagulation and prosthesis thrombosis with fear of anticoagulation-related bleeding. CONCLUSIONS: The totally thoracoscopic procedure on mitral valves by an experienced surgeon is technically feasible, safe, effective and worthy of widespread adoption in clinical practice.
format Online
Article
Text
id pubmed-6310972
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-63109722019-01-07 Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure Jiang, Qin Yu, Tao Huang, Keli Liu, Lihua Zhang, Xiaoshen Hu, Shengshou J Cardiothorac Surg Research Article BACKGROUND: The totally thoracoscopic procedure for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure’s feasibility, safety and effectiveness when it was performed by an experienced operator. METHODS: We retrospectively analysed 53 consecutive patients with MV disease treated between December 2014 and April 2017 by minimally invasive procedures. The procedures were performed on femoral artery-vein bypass through three 2–4 cm incisions, with one additional penetrating point on the right chest wall under totally thoracoscopic visual guidance and surveillance of transoesophageal echocardiography. RESULTS: Two patients who underwent intraoperative conversion to sternotomy were excluded due to indivisible pleural cavity adhesion. Of the others (38 female patients, average age, 49 ± 14 years, left ventricular ejection fraction, 59 ± 7%), 34 received MV replacement for rheumatic mitral lesions, which was redone for one patient after the discovery of serious paravalvular leakage, 17 received MV repair for mitral regurgitation (with 4 secondary to atrial septum defect, 2 diagnosed with left atrial myxoma, and 2 redone for mitral valve replacement due to repair failure), 28 received additional tricuspid valvuloplasty, and one patient received a Warden procedure. The cardiopulmonary bypass and aortic cross clamp times were 144 ± 39 min and 80 ± 22 min, respectively. Postoperational chest tube drainage in the first 48 h was 346 ± 316 ml. The ventilation time and intensive care unit stay length were 11 ± 11 h and 23 ± 2 h, respectively. One patient died of disseminated intravascular coagulation and prosthesis thrombosis with fear of anticoagulation-related bleeding. CONCLUSIONS: The totally thoracoscopic procedure on mitral valves by an experienced surgeon is technically feasible, safe, effective and worthy of widespread adoption in clinical practice. BioMed Central 2018-12-29 /pmc/articles/PMC6310972/ /pubmed/30594225 http://dx.doi.org/10.1186/s13019-018-0819-1 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Jiang, Qin
Yu, Tao
Huang, Keli
Liu, Lihua
Zhang, Xiaoshen
Hu, Shengshou
Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
title Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
title_full Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
title_fullStr Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
title_full_unstemmed Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
title_short Feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
title_sort feasibility, safety, and short-term outcome of totally thoracoscopic mitral valve procedure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310972/
https://www.ncbi.nlm.nih.gov/pubmed/30594225
http://dx.doi.org/10.1186/s13019-018-0819-1
work_keys_str_mv AT jiangqin feasibilitysafetyandshorttermoutcomeoftotallythoracoscopicmitralvalveprocedure
AT yutao feasibilitysafetyandshorttermoutcomeoftotallythoracoscopicmitralvalveprocedure
AT huangkeli feasibilitysafetyandshorttermoutcomeoftotallythoracoscopicmitralvalveprocedure
AT liulihua feasibilitysafetyandshorttermoutcomeoftotallythoracoscopicmitralvalveprocedure
AT zhangxiaoshen feasibilitysafetyandshorttermoutcomeoftotallythoracoscopicmitralvalveprocedure
AT hushengshou feasibilitysafetyandshorttermoutcomeoftotallythoracoscopicmitralvalveprocedure