Video-assisted mitral valve reoperation through a right minithoracotomy: A single-center experience

The study aim was to determine our results of minimally invasive technique without aortic cross clamping for mitral valve surgery after previous cardiac surgery.

We performed 24 consecutive mitral valve surgeries between January 2015 and December 2018 in patients with a history of previous cardiac surgery. The procedure was performed using video-assisted right minithoracotomy, femoro-femoral bypass, a temperature of 26 °C, and cardiopulmonary bypass without aortic cross-clamping.

Mitral valve replacement was performed in 12 (50%) of these patients, and mitral valve repair was performed in the same number (50%). The mean ejection fraction was 46.08±6.52% and the mean age was 61.52±11.48 years. Eighteen patients (75%) had previous coronary artery bypass graft surgery, and six patients (25%) had previous mitral valve surgery. In terms of postoperative complication frequencies that patients have experienced, one of the patients (4.1%) had postoperative low cardiac output syndrome. Two patients (8.3%) had renal failure; 2 patients (8.3%) had pneumonia, and stroke was seen in one patient (4.1%) postoperatively, whereas 2 patients (8.3%) had reoperation for bleeding. The mean postoperative packed red blood cell transfusion requirement at 48 hours was 1.00±1.10 units. The mean length of hospital stay was 10.54±4.37 days.

Minimally invasive port access procedure via right thoracotomy may be a safe and effective option in selected patients who need mitral surgery and have a history of prior sternotomy.