The Minimally Invasive Right Vertical Infra-axillary Lateral Minithoracotomy Approach For The Heart Valve Surgery: Report of 115 Cases

Abstract

Objective: We have developed a minimally invasive technique for heart valve replacements through a lateral mini-thoracotomy via a small right infra-axillary skin incision, and have evaluated its initial results. Methods: Through right vertical infra-axillary lateral minithoracotomy incision (by third intercostal space), 106 patients with rheumatic heart valve disease underwent heart valve surgery, 4 patients with left atrial myxsoma and 5 patient with large atrial septal defect underwent open heart operation are included in this study from July 2012 to December 2015. Results: 42 isolated mitral valve replacements, 7 mitral valve replacements and DeVega tricuspid annuloplasty, 3 mitral and tricuspid valve replacement, 2 mitral valve replacement and right coronary artery bypass graft, 1 reoperative mitral valve replacement due to dejeneration of the bioprothesis of the mitral valve, 6 mitral valve repair, 1 mitral valve repair and aortic valve replacement; 33 isolated aortic valve replacements, 9 aortic and mitral double valve replacements, 2 triple valve replacements, 4 excision of the left atrial myxsoma and 5 surgical closure of the large atrial septal defect were performed. There were 52 women (45%) and 63 men (55%). The mean and range of age was 48±9 (14-91). The length of the incision averaged 8.5±0.5 cm, There were 4 operative mortalities, one patient from infective endocarditis and multisystem organ failure, the other patients from cardiac failure in the hospital. The results of follow up for other patients were fine. Conclusions: This minimally invasive right vertical infra-axillary lateral minithoracotomy approach is safely, practicable, useful, economic, small wounded, cosmetic, contemporary and modern approach for the heart valve surgery