Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience
Background. Right thoracotomy is a well known alternative to median sternotomy to gain access to the left atrium. To avoid the potential drawbacks associated with sternotomy coupled to the desire for a smaller scar and a more rapid rehabilitation in young and active patients, we investigated the pur...
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| Veröffentlicht in: | The Annals of thoracic surgery 2001-09, Vol.72 (3), p.S1050-S1054 |
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| creator | Schroeyers, Pascal Wellens, Francis De Geest, Raf Degrieck, Ivan Van Praet, Frank Vermeulen, Yvette Vanermen, Hugo |
| description | Background. Right thoracotomy is a well known alternative to median sternotomy to gain access to the left atrium. To avoid the potential drawbacks associated with sternotomy coupled to the desire for a smaller scar and a more rapid rehabilitation in young and active patients, we investigated the purported advantages in patients undergoing video-assisted Port-Access mitral valve surgery.
Methods. Between February 1997 and November 2000, 175 patients (94 men, 81 women) with a mean age of 60 years (range 25 to 84) underwent either Port-Access mitral valve repair (n = 117) or replacement (n = 57) for degenerative disease (n = 112), rheumatic disease (n = 36), chronic endocarditis (n = 15), annular dilatation (n = 8), sclerotic disease (n = 2), and ingrowing myxoma (n = 1). There was one closure of a preexisting paravalvular leak. Standard Carpentier-Edwards repair procedures were used in all patients; in 14 patients polytetrafluoroethylene chordae were inserted for anterior leaflet prolapse. A total of 74 patients (42%) were in New York Heart Association functional class III/IV.
Results. Hospital mortality was 1.1% (n = 2). Four patients had conversion to sternotomy and conventional extra corporeal circulation for repair of a dissected aorta (n = 2) or the inabilty to proceed to a safe femoral cannulation (n = 2). Sixteen patients (9%) underwent a revision for bleeding. Mean cross-clamp time and perfusion time was 95 minutes (range 24 to 160) and 135 minutes (range 75 to 215) respectively. Mean intensive care unit and total hospital stay was 1.8 days (1 to 30) and 8.7 days (4 to 36), respectively. Three patients experienced late acute endocarditis: 2 had late mitral valve replacements and 1 patient had medical therapy for late prosthetic valve endocarditis. There were no myocardial infarctions, cerebrovascular events or peripheral ischemia due to thromboembolic phenomena. No wound complications were observed. The degree of patient satisfaction was very high.
Conclusions. The video-assisted Port-Access mitral valve approach is a valid alternative to sternotomy, with the same standards of results and quality. |
| doi_str_mv | 10.1016/S0003-4975(01)02974-5 |
| format | Article |
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Methods. Between February 1997 and November 2000, 175 patients (94 men, 81 women) with a mean age of 60 years (range 25 to 84) underwent either Port-Access mitral valve repair (n = 117) or replacement (n = 57) for degenerative disease (n = 112), rheumatic disease (n = 36), chronic endocarditis (n = 15), annular dilatation (n = 8), sclerotic disease (n = 2), and ingrowing myxoma (n = 1). There was one closure of a preexisting paravalvular leak. Standard Carpentier-Edwards repair procedures were used in all patients; in 14 patients polytetrafluoroethylene chordae were inserted for anterior leaflet prolapse. A total of 74 patients (42%) were in New York Heart Association functional class III/IV.
Results. Hospital mortality was 1.1% (n = 2). Four patients had conversion to sternotomy and conventional extra corporeal circulation for repair of a dissected aorta (n = 2) or the inabilty to proceed to a safe femoral cannulation (n = 2). Sixteen patients (9%) underwent a revision for bleeding. Mean cross-clamp time and perfusion time was 95 minutes (range 24 to 160) and 135 minutes (range 75 to 215) respectively. Mean intensive care unit and total hospital stay was 1.8 days (1 to 30) and 8.7 days (4 to 36), respectively. Three patients experienced late acute endocarditis: 2 had late mitral valve replacements and 1 patient had medical therapy for late prosthetic valve endocarditis. There were no myocardial infarctions, cerebrovascular events or peripheral ischemia due to thromboembolic phenomena. No wound complications were observed. The degree of patient satisfaction was very high.
Conclusions. The video-assisted Port-Access mitral valve approach is a valid alternative to sternotomy, with the same standards of results and quality.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(01)02974-5</identifier><identifier>PMID: 11565725</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cardiac Surgical Procedures - methods ; Cardiology. Vascular system ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Heart Valve Prosthesis Implantation ; Humans ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; Mitral Valve - surgery ; Patient Satisfaction ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Sternum - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Video-Assisted Surgery</subject><ispartof>The Annals of thoracic surgery, 2001-09, Vol.72 (3), p.S1050-S1054</ispartof><rights>2001 The Society of Thoracic Surgeons</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-e2ae48b738edff3af8d98e2d4967db6fddf757394e5c42cbd78178f97fc494d93</citedby><cites>FETCH-LOGICAL-c494t-e2ae48b738edff3af8d98e2d4967db6fddf757394e5c42cbd78178f97fc494d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(01)02974-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,777,781,786,787,3537,23911,23912,25121,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14069416$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11565725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schroeyers, Pascal</creatorcontrib><creatorcontrib>Wellens, Francis</creatorcontrib><creatorcontrib>De Geest, Raf</creatorcontrib><creatorcontrib>Degrieck, Ivan</creatorcontrib><creatorcontrib>Van Praet, Frank</creatorcontrib><creatorcontrib>Vermeulen, Yvette</creatorcontrib><creatorcontrib>Vanermen, Hugo</creatorcontrib><title>Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. Right thoracotomy is a well known alternative to median sternotomy to gain access to the left atrium. To avoid the potential drawbacks associated with sternotomy coupled to the desire for a smaller scar and a more rapid rehabilitation in young and active patients, we investigated the purported advantages in patients undergoing video-assisted Port-Access mitral valve surgery.
Methods. Between February 1997 and November 2000, 175 patients (94 men, 81 women) with a mean age of 60 years (range 25 to 84) underwent either Port-Access mitral valve repair (n = 117) or replacement (n = 57) for degenerative disease (n = 112), rheumatic disease (n = 36), chronic endocarditis (n = 15), annular dilatation (n = 8), sclerotic disease (n = 2), and ingrowing myxoma (n = 1). There was one closure of a preexisting paravalvular leak. Standard Carpentier-Edwards repair procedures were used in all patients; in 14 patients polytetrafluoroethylene chordae were inserted for anterior leaflet prolapse. A total of 74 patients (42%) were in New York Heart Association functional class III/IV.
Results. Hospital mortality was 1.1% (n = 2). Four patients had conversion to sternotomy and conventional extra corporeal circulation for repair of a dissected aorta (n = 2) or the inabilty to proceed to a safe femoral cannulation (n = 2). Sixteen patients (9%) underwent a revision for bleeding. Mean cross-clamp time and perfusion time was 95 minutes (range 24 to 160) and 135 minutes (range 75 to 215) respectively. Mean intensive care unit and total hospital stay was 1.8 days (1 to 30) and 8.7 days (4 to 36), respectively. Three patients experienced late acute endocarditis: 2 had late mitral valve replacements and 1 patient had medical therapy for late prosthetic valve endocarditis. There were no myocardial infarctions, cerebrovascular events or peripheral ischemia due to thromboembolic phenomena. No wound complications were observed. The degree of patient satisfaction was very high.
Conclusions. The video-assisted Port-Access mitral valve approach is a valid alternative to sternotomy, with the same standards of results and quality.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cardiology. Vascular system</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Mitral Valve - surgery</subject><subject>Patient Satisfaction</subject><subject>Postoperative Complications</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Sternum - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Video-Assisted Surgery</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v1DAQhi0EotvSnwDyBQSHUNux45gLQlUplYp6oD1WltceI1feZOtJou6_J_sheuzJGs3zjmceQt5z9pUz3pz9YYzVlTRafWb8CxNGy0q9IguulKgaocxrsviPHJFjxIe5FHP7LTniXDVKC7Ug979Tl1Yu5w1N3eQwTUCnFKCvHGLCAQJdpaG4TCeX5x6O5S-UzTfaj4VmQOw7pC4OUKijstqAKxSe1lASdB7ekTfRZYTTw3tC7n5e3J7_qq5vLq_Of1xXXho5VCAcyHap6xZCjLWLbTAtiCBNo8OyiSFErXRtJCgvhV8G3XLdRqPjNh9MfUI-7eeuS_84Ag52ldBDzq6DfkSrOTeCSzWDag_60iMWiHZd5vPLxnJmt17tzqvdSrOM251Xu819OHwwLlcQnlMHkTPw8QA49C7H4jqf8JmTrDGSNzP3fc_BrGNKUCz6naqQCvjBhj69sMo_q5-WLg</recordid><startdate>20010901</startdate><enddate>20010901</enddate><creator>Schroeyers, Pascal</creator><creator>Wellens, Francis</creator><creator>De Geest, Raf</creator><creator>Degrieck, Ivan</creator><creator>Van Praet, Frank</creator><creator>Vermeulen, Yvette</creator><creator>Vanermen, Hugo</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010901</creationdate><title>Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience</title><author>Schroeyers, Pascal ; Wellens, Francis ; De Geest, Raf ; Degrieck, Ivan ; Van Praet, Frank ; Vermeulen, Yvette ; Vanermen, Hugo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-e2ae48b738edff3af8d98e2d4967db6fddf757394e5c42cbd78178f97fc494d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Cardiology. Vascular system</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Mitral Valve - surgery</topic><topic>Patient Satisfaction</topic><topic>Postoperative Complications</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Sternum - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Video-Assisted Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schroeyers, Pascal</creatorcontrib><creatorcontrib>Wellens, Francis</creatorcontrib><creatorcontrib>De Geest, Raf</creatorcontrib><creatorcontrib>Degrieck, Ivan</creatorcontrib><creatorcontrib>Van Praet, Frank</creatorcontrib><creatorcontrib>Vermeulen, Yvette</creatorcontrib><creatorcontrib>Vanermen, Hugo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schroeyers, Pascal</au><au>Wellens, Francis</au><au>De Geest, Raf</au><au>Degrieck, Ivan</au><au>Van Praet, Frank</au><au>Vermeulen, Yvette</au><au>Vanermen, Hugo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2001-09-01</date><risdate>2001</risdate><volume>72</volume><issue>3</issue><spage>S1050</spage><epage>S1054</epage><pages>S1050-S1054</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. Right thoracotomy is a well known alternative to median sternotomy to gain access to the left atrium. To avoid the potential drawbacks associated with sternotomy coupled to the desire for a smaller scar and a more rapid rehabilitation in young and active patients, we investigated the purported advantages in patients undergoing video-assisted Port-Access mitral valve surgery.
Methods. Between February 1997 and November 2000, 175 patients (94 men, 81 women) with a mean age of 60 years (range 25 to 84) underwent either Port-Access mitral valve repair (n = 117) or replacement (n = 57) for degenerative disease (n = 112), rheumatic disease (n = 36), chronic endocarditis (n = 15), annular dilatation (n = 8), sclerotic disease (n = 2), and ingrowing myxoma (n = 1). There was one closure of a preexisting paravalvular leak. Standard Carpentier-Edwards repair procedures were used in all patients; in 14 patients polytetrafluoroethylene chordae were inserted for anterior leaflet prolapse. A total of 74 patients (42%) were in New York Heart Association functional class III/IV.
Results. Hospital mortality was 1.1% (n = 2). Four patients had conversion to sternotomy and conventional extra corporeal circulation for repair of a dissected aorta (n = 2) or the inabilty to proceed to a safe femoral cannulation (n = 2). Sixteen patients (9%) underwent a revision for bleeding. Mean cross-clamp time and perfusion time was 95 minutes (range 24 to 160) and 135 minutes (range 75 to 215) respectively. Mean intensive care unit and total hospital stay was 1.8 days (1 to 30) and 8.7 days (4 to 36), respectively. Three patients experienced late acute endocarditis: 2 had late mitral valve replacements and 1 patient had medical therapy for late prosthetic valve endocarditis. There were no myocardial infarctions, cerebrovascular events or peripheral ischemia due to thromboembolic phenomena. No wound complications were observed. The degree of patient satisfaction was very high.
Conclusions. The video-assisted Port-Access mitral valve approach is a valid alternative to sternotomy, with the same standards of results and quality.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11565725</pmid><doi>10.1016/S0003-4975(01)02974-5</doi></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Cardiac Surgical Procedures - methods Cardiology. Vascular system Endocardial and cardiac valvular diseases Female Heart Heart Valve Prosthesis Implantation Humans Length of Stay Male Medical sciences Middle Aged Minimally Invasive Surgical Procedures - methods Mitral Valve - surgery Patient Satisfaction Postoperative Complications Reoperation Retrospective Studies Sternum - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Video-Assisted Surgery |
| title | Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience |
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