Right mini-thoracotomy approach in patients undergoing redo mitral valve procedure

Area of Science:

• Cardiac Surgery
• Minimally Invasive Procedures
• Valve Repair and Replacement

Background:

• Minimally invasive cardiac surgery (MICS) presents an attractive alternative to traditional sternotomy.
• Reoperative mitral valve surgery poses unique challenges, often requiring specialized techniques.

Purpose of the Study:

• To evaluate the safety and feasibility of MICS using a right mini-thoracotomy approach for mitral valve reoperations.
• To assess outcomes in patients undergoing repeat mitral valve procedures via this minimally invasive technique.

Main Methods:

• A cohort of 20 patients undergoing reoperative mitral valve surgery between 2017 and 2019 utilized a right mini-thoracotomy.
• Cardiopulmonary bypass was established via femoral vessel cannulation.
• Exclusion criteria included concomitant coronary artery bypass grafting (CABG) or peripheral artery disease.

Main Results:

• The study included patients with a mean age of 65 years and an average log. EuroSCORE of 9%.
• Ten patients underwent mitral valve re-repair for severe mitral regurgitation, while ten underwent valve replacement.
• In-hospital mortality was 5%, with a 1- and 2-year survival rate of 95%. Postoperative echocardiography confirmed competent valve function.

Conclusions:

• Minimally invasive cardiac surgery (MICS) through a right mini-thoracotomy is a safe and feasible option for selected patients requiring mitral valve reoperation.
• This technique provides a valuable surgical choice for high-risk individuals needing repeat mitral valve procedures.