OC42 MINIMALLY INVASIVE MITRAL VALVE SURGERY IN HIGH-RISK PATIENTS: 12-YEAR SINGLE CENTRE EXPERIENCE

Abstract

Objective: This study analyzed the results of 12-year experience with mini-invasive MV operations in high-risk patients. Methods: From 1/2006 to 2/2018, 153 patients with EuroSCORE ≥ 10 underwent minimally invasive MV surgery (13.0% of 1175): mean EuroSCORE was 12.0 ± 3.1 and Logistic was 30.7 ± 15.8, mean age was 73.6 ± 8.6, male were 32.7%. Comorbidities included: diabetes (23.5%), COPD (24.2%), chronic renal failure (28.1%), peripheral vasculopathy (16.3%), previous AMI (10.5%), neurological deficit (13.7%), active endocarditis (9.2%) and AF (63.4%). The mean EF was 50.7 ± 13.8 and 34.0% had pulmonary hypertension. In 71.2% had undergone previous cardiac surgery, in 11.1% were urgiences. Results: In 24.8% were mitral repair, associated procedures were TV procedures (20.3%) and AF-crioablation (5.3%). Mean cardiopulmonary and cross clamp time were respectively 133.8 ± 54.1 and 83.8 ± 28.5 minutes. The most utilized aortic clamp technique was endoreturn (58.8%). Conversions to sternotomy were 4.6%. Reoperation for bleeding occured in 11.8%. Postoperatively, in 2.6% were reported major neurologic complications, in 14% was necessary CVVH, in 5.2% PM implantation and in 6.5% tracheostomy. Mean, median intubation time, ICU and hospital stay were respectively 135.3 ± 833.9 (12)h, 9.7 ± 36.0 (2)days and 20.1 ± 39.1 (10)days. The 30-day mortality rate was 9.2%. Conclusions: mini-invasive approach allows acceptable morbidity and mortality in high-risk patients.