158: Minimally invasive approach for mitral valve surgery, as safe and as reliable than sternotomy. Does it should be the standard approach? Experience in 368 patients

Abstract

To assess the reliability of minimally invasive approach, as this approach is contest in France we review part of our experience in one center. From January 2009 to April 2012, 368 patients were operated of isolated mitral surgery in a single center. In a retrospective study we analyze follow-up with focus on surgical approach to emphasize on the safety of minimally invasive strategy. During that period video-assisted procedure was perform for 222 patients and 146 underwent standard sternotomy. Results on different parameters are analyzed, we report no difference in mortality, in-hospital stay length, stroke, bleeding, use of catecholamine between the two groups. Cross clamping, ECC times were longer in minimally invasive group. ICU time was longer in standard sternotomy group. In terms of results in efficiency upon plasty results, results were better in the minimally invasive group with 90,4% success of plasty when planned. All parameters are detailed in the study. Reliability of the procedure is modulated by experience of surgeon, two surgeons are mainly involved in minimally invasive program, they are more experienced in mitral plasty so that explain good repair vs replacement rate in this group. On the basis of this retrospective study we conclude than minimally invasive approach is as safe as standard approach for mitral surgery and as reliable on repair rate in mitral regurgitation.