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Outcomes of Minimally Invasive Valve Surgery in Patients with Multiple Previous Cardiac Operations

Orlando Santana1, Rama Krishna1, Nisharahmed Kherada1

  • 1Columbia University, Mount Sinai Heart Institute, Miami Beach FL, USA.

The Journal of Heart Valve Disease
|December 24, 2016
PubMed

Insights

Minimally invasive reoperative valve surgery is safe for patients with multiple prior cardiac surgeries. This approach offers good perioperative outcomes and mid-term survival rates.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Background:

  • Evaluating outcomes of minimally invasive valve surgery in patients with extensive prior cardiac operations.
  • Focus on right anterior thoracotomy approach for reoperative valve procedures.

Purpose of the Study:

  • Assess safety and feasibility of minimally invasive valve surgery in patients with >2 prior cardiac surgeries.
  • Analyze perioperative outcomes and mid-term survival in this high-risk cohort.

Main Methods:

  • Retrospective review of minimally invasive valve operations.
  • Inclusion criteria: patients with ≥2 prior cardiac surgeries (coronary artery bypass grafting and/or valve surgery).
  • Data collected between January 2008 and November 2014.

Main Results:

  • 38 patients identified with complex surgical histories.
  • Common procedures included mitral and aortic valve operations.
  • Perioperative complications: cerebrovascular accidents (5.3%), reoperation for bleeding (7.9%), acute kidney injury (7.9%).
  • 30-day mortality: 7.9%.
  • 5-year survival: 72%.

Conclusions:

  • Minimally invasive reoperative valve surgery is safe and feasible in patients with multiple prior cardiac operations.
  • The approach demonstrates good perioperative results.
  • Favorable mid-term survival rates support this technique for selected patients.
Abstract

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