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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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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 |
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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 |
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