Three-year follow-up after port-access mitral valve surgery

After the promising early results with Port-Access mitral valve (MV) surgery, the mid-term results were evaluated.

Among 31 patients receiving this surgery, there were two subgroups (A and B). The 14 patients in group A (7 men, 7 women, 64.0 +/- 12.8 years, LVEF 0.62 +/- 0.118) received the procedure exactly as proposed by Heartport. The 17 patients in group B (6 men, 11 women, 63.0 +/- 11.48 years, LVEF 0.61 +/- 0.117) received a modified technique for a less complex procedure. The underlying diseases were MV insufficiency (n = 14), MV stenosis (n = 9), and combined MV disease (n = 8). One female patient had a partial atrial ventricular canal.

Perioperative mortality was 3.2%. Survival at 39.0 +/- 6.3 months (median +/- SEM) was 93.5%. Two patients required intraoperative inotropic and mechanical support (intra-aortic balloon pump [IABP]). One of these two patients died on postoperative day 3 due to low cardiac output syndrome. All ther patients survived the procedure. Twenty-four patients underwent MV replacement, 7 patients received MV repair, and 1 patient received, in addition, ASD repair. In group B, operative time, ICU stay, and hospitalization was shorter.

Good early results after Port-Access MV surgery were confirmed by equal mid-term results. The patients are satisfied with the surgical and the cosmetic results, however, Port-Access MV surgery still has to prove superior outcome compared to conventional MV surgery. In selected cases a true reduction of the surgical trauma is possible.