A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery.

Abstract

Background There is now extension of minimally invasive techniques to involve concomitantly aortic and mitral valves through a single small incision. We share our experience in such surgeries through upper partial sternotomy with approaching the mitral valve through the dome of the left atrium. Methods Two matched groups of cases receiving concomitant aortic and mitral valve surgeries are compared regarding the surgical outcomes: the minimally invasive group (group A) including 72 patients and the conventional group (group B) including 78 patients. Results The mean age was 52 ± 8 years in group A and 53 ± 7 years in group B. Males represented (42%) in group A and (49%) in group B. The mean mechanical ventilation time was significantly shorter in group A (4.3 ± 1.2 hours) than in group B (6.1 ± 0.8 hours) with a p -value of 0.001. In addition, the amount of chest tube drainage and the need for blood transfusion units were significantly less in group A (250 ± 160 cm 3 and 1.3 ± 0.8 units, respectively) when compared with group B (320 ± 180 cm 3 and 1.8 ± 0.9 units, respectively) with p -values of 0.013 and 0.005, respectively. Over a follow-up period of 3.2 ± 1.1 years, one mortality occurred in each group with no significant difference ( p -value = 0.512). Conclusion Combined aortic and mitral valve surgery through upper partial sternotomy with approaching the mitral valve through the dome of the left atrium is safe and effective with the advantages of less postoperative blood loss, need for blood transfusion, and mechanical ventilation time compared with conventional aortic and mitral valve surgery.