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

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. Met...

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Autores principales: Alkady, Hesham, Abouramadan, Sobhy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913047/
https://www.ncbi.nlm.nih.gov/pubmed/34963177
http://dx.doi.org/10.1055/s-0041-1740240
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author Alkady, Hesham
Abouramadan, Sobhy
author_facet Alkady, Hesham
Abouramadan, Sobhy
author_sort Alkady, Hesham
collection PubMed
description 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 cm (3) and 1.3 ± 0.8 units, respectively) when compared with group B (320 ± 180 cm (3) 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.
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spelling pubmed-89130472022-03-11 A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery Alkady, Hesham Abouramadan, Sobhy Thorac Cardiovasc Surg 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 cm (3) and 1.3 ± 0.8 units, respectively) when compared with group B (320 ± 180 cm (3) 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. Georg Thieme Verlag KG 2021-12-28 /pmc/articles/PMC8913047/ /pubmed/34963177 http://dx.doi.org/10.1055/s-0041-1740240 Text en 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/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Alkady, Hesham
Abouramadan, Sobhy
A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery
title A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery
title_full A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery
title_fullStr A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery
title_full_unstemmed A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery
title_short A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery
title_sort simple approach for minimally invasive combined aortic and mitral valve surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913047/
https://www.ncbi.nlm.nih.gov/pubmed/34963177
http://dx.doi.org/10.1055/s-0041-1740240
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