Minimally invasive mitral valve surgery after previous sternotomy: experience in 181 patients.

摘要: Objective This study evaluated the results for minimally invasive mitral valve (MV) surgery in patients who had undergone previous cardiac operations through a sternotomy. Methods From March 1, 1999 to January 2008, MV reoperations were performed 181 consecutive (110 men) with mean age of 64.5 ± 12 years. A right-sided lateral minithoracotomy femoral cannulation cardiopulmonary bypass (CPB) was used. The principal indication symptomatic severe regurgitation (mean grade, 3.0 0.8). Previous procedures isolated coronary grafting (CABG) 76 (42%), operation, 55 (30%); combined CABG and valve, 16 (9%); other operations, 34 (19%). replacement previously 19 repair 31. Mean preoperative left ventricular ejection fraction 0.54 0.16. Results repair, including repeat 109 (60%) 72 (40%). Operations during fibrillation 140 (77%), transthoracic aortic cross-clamp used 31 (17%). Ten (6%) underwent beating heart CPB support. total operating time 176 50 min. 135 40 Thirty-day mortality 6.6%. Early echocardiographic follow-up revealed excellent function most patients. Conclusion approach is useful alternative requiring procedure after particularly patent grafts or replacement. Very good perioperative can be achieved this method.