EP32 RESECT OR RESPECT: THE OUTCOME IN MITRAL VALVE REPAIR THROUGHT MINITORACOTHOMY

Abstract

Abstract Background and aim: Heart valve surgery through right anterior minithoracotomy proved excellent short-term and long-term-term results, becoming a feasible alternative to the sternotomy approach. Surgical repair is the gold standard therapy for mitral valve regurgitation. Recently, the valve sparing techniques has been established and it is preferred by many surgeons. The aim of this retrospective study is to show the results of mortality and freedom from reoperation in patients underwent mitral repair with a leaflet sparing or resection techniques. Methods: from January 2010 to February 2017, 366 patients underwent mitral valve repair; leaflet sparing technique was performed in 187patients (51%), resection in 179 patients (49%). Minitoracothomy was performed throught a 5 cm incision at the fourth intercostal space. We adopted an aortic central cannulation with a percutaneous peripheral venous cannulation. Aortic cross clamping was perfomed by a transcutaneous clamp at the second intercostal space. The mean follow-up was 35 mounths. Results: The mean age was 62,5 ± 12,8 years. The 30-day mortality was 0,27% (0% in leaflet sparing group). The follow up mortality was 0.82 % (0% in leaflet sparing group). At discharge moderate mitral regurgitation was present in 5 patient (2.7%) in leaflet sparing group, in 16 patients (8.9%) in the other group. Freedom from reintervention at 1 year was 97.9% in leaflet sparing group and 95,0% in the other one. Conclusion: this study shows that leaflet sparing techniques combined with minimally invasive access has good results in terms of mortality and freedom from reoperation.