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Updated: May 11, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Thoracic epidural anesthesia improves early outcome in patients undergoing cardiac surgery for mitral regurgitation:
Fabrizio Monaco1, Camilla Biselli, Giovanni Landoni
1Anesthesia and Intensive Care Department, San Raffaele Scientific Institute, Milan, Italy.
Objective:
There are no large studies that investigate the effect of thoracic epidural anesthesia (TEA) combined with general anesthesia (GA) in patients undergoing valvular surgery. The authors hypothesized that TEA might improve clinically relevant endpoints in patients with primary mitral regurgitation.
Design:
Propensity-matched study.
Setting:
Cardiac surgery.
Participants:
Patients scheduled for mitral valve repair or replacement were studied.
Interventions:
A propensity model was constructed to match 33 patients receiving TEA combined with GA with 33 patients receiving standard GA alone.
Measurements And Main Results:
Overall, the TEA group suffered fewer adverse events than the GA group: 10 (30%) v 23 (10%) with p = 0.002. In particular, the TEA group had a lower incidence of pulmonary events, 6 (18%) v 15 (45%) with p = 0.02, and of cardiac events, 8 (24%) v 16 (49%) with p = 0.04. Median (interquartile) time on mechanical ventilation was reduced in the TEA group, 11 (9-15) v 17 (12-36) with p = 0.007.
Conclusions:
This propensity-matched study suggested that TEA might be advantageous in patients undergoing surgery for mitral regurgitation.
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