Anterolateral Minithoracotomy Mitral Valve Surgery with Central Cannulation: A Three-year Single-Center Experience

In recent years, minimally invasive mitral valve surgery has become a standard procedure all over the world. A simplified and reproducible technique for performing mitral valve surgery through a right minithoracotomy with central aortocaval cannulation from the same incision, utilizing conventional instruments, has been developed. This innovative approach eliminates the requirement for endoscopic assistance, femoral arterial cannulation, and associated complications. This study aims to analyze the outcomes of patients who underwent minimally invasive mitral valve replacements (MVRs) with central cannulation between January 2016 and June 2018.

To conduct this analysis, preoperative variables, intraoperative data, and postoperative outcomes of patients undergoing minimally invasive MVRs were prospectively collected in our database from January 2016 to June 2018.

A total of 350 patients underwent minimally invasive MVR surgery, with a mean age of 33.40 ± 10.89 years. Among them, 9.4% underwent concomitant procedures, such as tricuspid valve surgery and atrial septal defect closure. The mean cardiopulmonary bypass and cross-clamp times were 54.45 ± 4.95 min and 36.85 ± 4.39 min, respectively. Conversion to sternotomy was required in none of the patients. Major morbidities included stroke (n = 1; 0.29%) and new-onset dialysis requirement (n = 3; 0.85%). The mean blood transfusion requirement was 0.15 ± 0.27 units. The mean intensive care unit stay was 2.13 ± 0.32 days, and the hospital stay was 5.36 ± 1.12 days.

This study represents a valuable option in MVR surgery. Thoracotomy MVR is a safe and reproducible technique with excellent cosmesis.