Background
Following developments in the area of minimally invasive surgery and good, recently
published surgical results, the areas in which minimally invasive surgery can be used
are beginning to expand. This study aimed to describe experience and show the feasibility
and safety of minimally invasive multiple valve implantation with right anterior minithoracotomy
(RAT) and compare the outcomes with cases that underwent multiple valve surgery via
a standard median sternotomy.
Methods
The study cohort comprised 52 patients with combined valvular disease who underwent
aortic valve replacement and mitral valve replacement or repair, and/or tricuspid
valve ring annuloplasty through median sternotomy (control group n=32) or minimally
invasive surgery through a RAT (study group n=20) between January 2012 and December
2018 at the current centre. Preoperative evaluation included coronary catheterisation
and multisliced computerised tomography in all patients. Postoperative clinical outcomes
and haemodynamic performance of heart valves were reviewed.
Results
The mean age of patients was 72.6±7.1 years, and 50% were male. Seventeen (17) patients
(32.6%) were in New York Heart Association functional class III or IV. Three (3) patients
(7.6%) had third-degree atrioventricular block requiring permanent pacemaker implantation.
Mean follow-up was 21±3.9 months (maximum 26 months). No major paravalvular leakage
occurred, and there was no postoperative valve migration in either group. Non-valve-related
deaths occurred in five patients during follow-up.
Conclusion
This study showed that minimally invasive multiple valve implantation is a technically
feasible and safe procedure with acceptable surgical outcomes and similar postoperative
quality when compared with median sternotomy.
Keywords
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Article info
Publication history
Published online: February 18, 2020
Accepted:
January 16,
2020
Received in revised form:
December 9,
2019
Received:
July 14,
2019
Identification
Copyright
© 2020 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
