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Conference Paper: Minimally invasive direct access heart valve surgery

TitleMinimally invasive direct access heart valve surgery
Authors
Issue Date2000
Citation
Journal of Cardiac Surgery, 2000, v. 15 n. 1, p. 21-34 How to Cite?
AbstractWe review our experience with minimally invasive direct access (MIDA) heart valve surgery in 518 patients. Two hundred fifty-two patients underwent MIDA aortic valve replacement (AVR) or repair and 266 underwent MIDA mitral valve repair or replacement. Among the 250 AVRs, 157 (63%) were men, aged 63.2 ± 14.6 years, NYHA functional Class 2.4 ± 0.8. The surgical approach was right parasternal in 36 (14%) or upper hemisternotomy in 216 (86%). There were four (2%) operative deaths. Perioperative complications included 14 (5.6%) reexplorations for bleeding, 7 (3%) chest wound infections, 5 (2%) strokes, and 1 (0.4%) external iliac vein injury. Follow-up was complete in 193 (77%) patients, with a mean follow-up of 12 ± 8 months. Late complications included 2 (0.8%) nonfatal myocardial infarctions, 4 (2%) reoperations for, respectively, 2 pericardial complications, 1 paravalvar leak, and 1 infected valve. There were five (2%) late deaths from congestive heart failure, pneumonia, hemorrhage, aneurysm, and cancer. Mean follow-up NYHA Class was 1.4 ± 0.6. For the 266 mitral patients, 145 (54.5%) were men, age 58.7 ± 13.6 years, functional Class 2.3 ± 0.5. The surgical approach was right parasternal in 195 (73%), lower hemisternotomy in 53 (20%), right submammary thoracotomy in 9 (3.4%), or full sternotomy through a small skin incision in 9 (3.4%). There were 2 (0.8%) operative deaths. Perioperative complications included 4 (1.5%) reoperations for bleeding, 4 (1.5%) strokes, and 5 (2%) wound infections, and 3 (1%) ascending aortic complications. Follow-up was complete in 202 (76%) patients with a mean follow-up of 9.5 ± 6.4 months. Late complications included one (0.4%) nonfatal myocardial infarction and three (1%) reoperations all converting repairs to replacements. There were three (1%) late deaths from suicide, pneumonia, and sudden death, respectively. Mean follow-up NYHA functional Class was 1.3 ± 0.5. We conclude that MIDA heart valve surgery is safe and effective for the majority of patients requiring isolated elective aortic or mitral valve surgery.
Persistent Identifierhttp://hdl.handle.net/10722/192716
ISSN
2015 Impact Factor: 0.783
2015 SCImago Journal Rankings: 0.578
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorByrne, JGen_US
dc.contributor.authorHsin, MKen_US
dc.contributor.authorAdams, DHen_US
dc.contributor.authorAklog, Len_US
dc.contributor.authorAranki, SFen_US
dc.contributor.authorCouper, GSen_US
dc.contributor.authorRizzo, RJen_US
dc.contributor.authorCohn, LHen_US
dc.date.accessioned2013-11-20T04:58:23Z-
dc.date.available2013-11-20T04:58:23Z-
dc.date.issued2000en_US
dc.identifier.citationJournal of Cardiac Surgery, 2000, v. 15 n. 1, p. 21-34en_US
dc.identifier.issn0886-0440en_US
dc.identifier.urihttp://hdl.handle.net/10722/192716-
dc.description.abstractWe review our experience with minimally invasive direct access (MIDA) heart valve surgery in 518 patients. Two hundred fifty-two patients underwent MIDA aortic valve replacement (AVR) or repair and 266 underwent MIDA mitral valve repair or replacement. Among the 250 AVRs, 157 (63%) were men, aged 63.2 ± 14.6 years, NYHA functional Class 2.4 ± 0.8. The surgical approach was right parasternal in 36 (14%) or upper hemisternotomy in 216 (86%). There were four (2%) operative deaths. Perioperative complications included 14 (5.6%) reexplorations for bleeding, 7 (3%) chest wound infections, 5 (2%) strokes, and 1 (0.4%) external iliac vein injury. Follow-up was complete in 193 (77%) patients, with a mean follow-up of 12 ± 8 months. Late complications included 2 (0.8%) nonfatal myocardial infarctions, 4 (2%) reoperations for, respectively, 2 pericardial complications, 1 paravalvar leak, and 1 infected valve. There were five (2%) late deaths from congestive heart failure, pneumonia, hemorrhage, aneurysm, and cancer. Mean follow-up NYHA Class was 1.4 ± 0.6. For the 266 mitral patients, 145 (54.5%) were men, age 58.7 ± 13.6 years, functional Class 2.3 ± 0.5. The surgical approach was right parasternal in 195 (73%), lower hemisternotomy in 53 (20%), right submammary thoracotomy in 9 (3.4%), or full sternotomy through a small skin incision in 9 (3.4%). There were 2 (0.8%) operative deaths. Perioperative complications included 4 (1.5%) reoperations for bleeding, 4 (1.5%) strokes, and 5 (2%) wound infections, and 3 (1%) ascending aortic complications. Follow-up was complete in 202 (76%) patients with a mean follow-up of 9.5 ± 6.4 months. Late complications included one (0.4%) nonfatal myocardial infarction and three (1%) reoperations all converting repairs to replacements. There were three (1%) late deaths from suicide, pneumonia, and sudden death, respectively. Mean follow-up NYHA functional Class was 1.3 ± 0.5. We conclude that MIDA heart valve surgery is safe and effective for the majority of patients requiring isolated elective aortic or mitral valve surgery.en_US
dc.languageengen_US
dc.relation.ispartofJournal of Cardiac Surgeryen_US
dc.titleMinimally invasive direct access heart valve surgeryen_US
dc.typeConference_Paperen_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1540-8191.2000.tb00441.x-
dc.identifier.pmid11204384-
dc.identifier.scopuseid_2-s2.0-0034443620en_US
dc.identifier.volume15en_US
dc.identifier.issue1en_US
dc.identifier.spage21en_US
dc.identifier.epage34en_US
dc.identifier.isiWOS:000166654100006-

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