P346 MINIMALLY INVASIVE APPROACH FOR THE SURGICAL TREATMENT OF COMBINED MITRAL AND AORTIC VALVE DISEASE

Abstract

Abstract Background Minimally invasive approaches are more and more used for isolated aortic or mitral valve procedures. However, minimally invasive combined mitral and aortic valve surgery is still uncommon. We report our experience performing multiple valve procedures through a right–sided mini–thoracotomy. Methods From November 2013 to July 2022, 32 patients underwent aortic and mitral valve surgery through right anterior thoracotomy. Results Median (Q1–Q3) age of our population was 71 years (59,5–76) and 59% were females. Median (Q1–Q3) logistic Euroscore was 3.99 (2.52–6.76) and median (Q1–Q3) EuroSCORE II was 2.28 (1.81–5.42). Three patients (9%) were redo operations. Median cardiopulmonary bypass and cross–clamp times were 95 (83–118) minutes and 83 (71–104) minutes, respectively. No conversion to full sternotomy was necessary. In–hospital mortality was 3.1% (1 patient) who died for septic shock and consequent multi–organ failure. 62% of patients required transfusions with packed blood cells. Post–operative atrial fibrillation was observed in 8 patients (25%) and 2 patient (6%) required Pace–maker implantation due to third degree AV block. Also, 1 (3%) re–thoracotomy for bleeding was observed. Median (Q1–Q3) intensive care unit and in–hospital length of stay were 2 (2–3) days and 9 (8–11) days respectively. Median follow up period was 5.5 years (1.4–6.3) with 87.5% survival rate (incidence rate of death: 2.8 per 100 patient–years). Re–operation rate was 9.4%. Conclusions In our experience, a minimally invasive approach for combined aortic and mitral valve surgery is safe and feasible, with acceptable cardiopulmonary bypass and cross–clamp times and good outcomes. Therefore, it can be an attractive option for patients with double valve diseases. Further studies are needed with a bigger population and a comparison to full sternotomy results.