Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: A propensity-matched comparison

摘要: Objective Minimally invasive approaches to mitral valve surgery are increasingly used, but the surgical approach must not compromise clinical outcome for improved cosmesis. We examined outcomes of repair performed through right minithoracotomy or median sternotomy. Methods Between January 2002 and October 2011, 1011 isolated repairs were in University Pennsylvania health system (455 sternotomies, 556 minithoracotomies). To account key differences preoperative risk profiles, propensity scores identified 201 well-matched patient pairs with regurgitation any cause 153 myxomatous disease. Results In-hospital mortality was similar between propensity-matched groups (0% vs 0% degenerative cohort; 0.5%, P  = .5 overall minimally sternotomy groups, respectively). Incidence stroke, infection, myocardial infarction, exploration postoperative hemorrhage, renal failure, atrial fibrillation also comparable. Transfusion less frequent (11.8% 20.3%,  = .04 14.0% 22.9%,  = .03 cohort), time extubation discharge similar. A 99% rate achieved patients disease, a did significantly increase likelihood failed resulting replacement. Patients undergoing more likely have no residual post-repair (97.4% 92.1%, 95.5% 89.6%,  = .02 cohort). In matched cohort, early readmission rates higher sternotomies (12.6% 4.4%,  = .01). Over 9 years follow-up, there significant difference long-term survival (  = .8). Conclusions appropriate disease cause, may be used without compromising outcome.