International Journal of Health and Clinical Research

Yazarlar: Piyush Gupta, Abhishek Rathore, Manish Porwal

Konular:-

Anahtar Kelimeler:Minimally invasive,Minithoracotomy,Mitral valve replacement,Mini,VR.

Özet: Background: Mitral valve replacement (MVR) through minimally invasive approaches has grown in popularity over past few decades as it offers multiple advantages over conventional full sternotomy approach. We analysed our single centre experience of MVR through the right minithoracotomy (Mini-MVR) performed over a three year period. Methods: This study was a retrospective analytical study done at CHL hospital, Indore. Fifty eight patients undergoing MVR through the right minithoracotomy between January 2018 and December 2021 were included. Records of perioperative data were collected and retrospectively evaluated. Results: Total 58 patients were included in the study, of which 42 were females (72.4%). Mean age was 41.2+/- 8.9 years. Overall 30-day mortality was 1.72% (n = 1). Mean operative time, cardiopulmonary bypass, and aortic cross-clamp times were 261.9 ± 52.7, 149.5 ± 42.8, and 91.8 ± 24.6 minutes, respectively. Tricuspid valve annuloplasty was performed in 11 patients (18.9%). Two patients (3.45%) required conversion to median sternotomy and three patients (5.2%) underwent re-explorations due to bleeding. Median intensive care unit stay (ICU) was 36 hours and median postoperative hospital stay was 5 days. There was no incidence of stoke in any patient during hospital stay. Wound healing of chest and groin wound was excellent. Conclusions: MVR through the right minithoracotomy approach is feasible, reproducible, safe and effective with low mortality and morbidity. Mini-MVR is good alternative to conventional sternotomy. Besides certain cosmetic advantage, it avoids potentially devastating infective complications of mediastinitis/sternal dehiscence while shortening ICU and total hospital stay and reducing recovery time with early return to work.

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