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Mitral valve surgery using the classical 'heartport' technique.

William H Ryan1, Todd M Dewey, Michael J Mack

  • 1Cardiopulmonary Research Science and Technology Institute, Dallas, Texas, USA.

The Journal of Heart Valve Disease
|December 20, 2005
PubMed
Summary
This summary is machine-generated.

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Minimally invasive mitral valve surgery using the Heartport (HP) approach demonstrated comparable 30-day outcomes to conventional sternotomy (SP) despite longer cross-clamp times. This approach is safe and effective for mitral valve repair and replacement.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Cardiac Surgery
  • Mitral Valve Surgery

Background:

  • Minimally invasive mitral valve surgery via femoral cannulation and thoracotomy (Heartport - HP) is perceived as higher risk than conventional sternotomy (SP).
  • This study compares the operative risk and early outcomes of the initial 117 HP cases against a matched SP cohort.

Purpose of the Study:

  • To assess the operative risk and 30-day outcomes of mitral valve surgery performed using the Heartport (HP) approach.
  • To compare HP approach outcomes with conventional sternotomy (SP) in a matched patient cohort.

Main Methods:

  • Retrospective analysis of 117 patients undergoing mitral valve surgery via the Heartport (HP) approach (92 repairs, 25 replacements).
  • Patients were intention-to-treat and matched 1:1 to a sternotomy (SP) control group based on age, cerebrovascular disease, inotrope use, and ejection fraction.

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  • Operative and 30-day outcomes were compared between the HP and SP groups.

    • Main Results:

    • No significant differences in 30-day outcomes were observed between the HP and SP groups.
    • The HP group experienced longer cross-clamp and perfusion times compared to the SP group.
    • Rare complications in the HP group included coronary sinus perforation requiring conversion in two cases, and one case aborted due to aortic dissection.

    Conclusions:

    • The 'classical' Heartport (HP) approach for mitral valve surgery can be performed without increased operative risk compared to conventional sternotomy (SP), despite longer cross-clamp times.
    • Complications related to catheters and endoballoons were infrequent, even in early experience.
    • Conversion to sternotomy was uncommon and managed safely when necessary.