Minimally invasive port-access mitral valve surgery

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Medical Device Technology

Background:

• Minimally invasive cardiac surgery aims to reduce surgical trauma.
• Video-assisted techniques offer enhanced visualization during procedures.
• The Port-Access system is designed for closed-chest cardiac interventions.

Purpose of the Study:

• To evaluate the feasibility of the Port-Access system for video-assisted minimally invasive mitral valve surgery.
• To develop and assess a novel video-assisted surgical technique for mitral valve repair and replacement.
• To minimize surgical access and invasiveness in mitral valve procedures.

Main Methods:

• The study involved 51 patients undergoing mitral valve repair (n=28) or replacement (n=23).
• A minimally invasive approach was used via right lateral minithoracotomy under videoscopic guidance.
• The Port-Access system facilitated closed-chest endoluminal aortic clamping and cardioplegic arrest.

Main Results:

• The mean incision length was 5.4 cm, with operative times including cardiopulmonary bypass and cross-clamp durations reported.
• Median intubation, intensive care, and hospital stay were 25.5 hours, 2 days, and 13 days, respectively.
• Hospital mortality was 9.8%, with high overall morbidity including two cases of aortic dissection and three reoperations for paravalvular leakage.

Conclusions:

• The Port-Access system enables video-assisted minimally invasive mitral valve repair and replacement.
• The novel technique, while feasible, was associated with significant early morbidity and mortality.
• Further refinement and evaluation are necessary to improve outcomes for this minimally invasive approach.