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

Joerg Seeburger1, Michael A Borger, Volkmar Falk

  • 1Heart Center, Leipzig University, Leipzig, Germany. j.seeburger@web.de

The Annals of Thoracic Surgery
|February 24, 2009
PubMed
Abstract

Insights

Minimally invasive mitral valve surgery is a safe and effective option for patients needing repeat procedures after prior sternotomy. This approach yields good outcomes, offering a valuable alternative for complex cardiac cases.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Cardiac Surgery

Background:

  • Previous cardiac operations via sternotomy pose challenges for subsequent mitral valve surgery.
  • Symptomatic severe mitral regurgitation is a common indication for reoperation.

Purpose of the Study:

  • To evaluate the outcomes of minimally invasive mitral valve reoperations in patients with prior sternotomy.
  • To assess the feasibility and safety of a right-sided lateral minithoracotomy approach for mitral valve reoperations.

Main Methods:

  • 181 consecutive patients underwent minimally invasive mitral valve reoperations using a right-sided lateral minithoracotomy and femoral cannulation.
  • Procedures included mitral valve repair (60%) and replacement (40%).
  • Previous operations varied, including coronary bypass grafting and prior valve surgery.

Main Results:

  • Thirty-day mortality was 6.6%.
  • Mitral valve repair was performed in 109 patients, and replacement in 72.
  • Early echocardiographic follow-up demonstrated excellent valve function in most patients.

Conclusions:

  • Minimally invasive mitral valve surgery is a viable alternative for patients with previous cardiac operations.
  • This approach achieves very good perioperative results, especially in patients with patent coronary bypass grafts or prior aortic valve replacement.

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