|
P. Schroeyers, F. Wellens, R. DeGeest, I. Degrieck, F.
VanPraet, H. Vanermen
Cardiovascular Surgery, OLV Clinic, Aalst, Belgium.
Introduction:Video-assisted Mitral Valve Repair (MVR)
through Port-Access TM is a valid alternative for
mid-sternotomy. Mid-term results are not known yet.
Patients and methods: Between February 1997 and December
1999, 121 consecutive patients underwent mitral valve surgery
through a small right antero-lateral thoracotomy using the Heartport®
system, 77 patients underwent MVR. Severe (4+) mitral regurgitation
(MR) was seen in 63 patients (82%). Mean NYHA Class was 2,5 ±0,4.
Standard Carpentier MVR procedures were used in all patients;
11 had PTFE chordae for anterior leaflet prolapse.
Results: Hospital mortality was 1,3% (n=1). Two patients
(2,6%) had conversion to sternotomy for aortic dissection with
the Endo-Aortic Clamp. Mean cross clamp and mean perfusion time
were 103 min. (24-160) and 140 min. (75-215) respectively. At
clinical follow-up (19,6 months, range 5-41) all patients improved
their NYHA class. At echocardiography, LV end-diastolic and LV
end-systolic diameters decreased from 61 ±7,3 to 53± 6,9 (p<0,01)
and 37±6,8 to 34±6,9 (p<0,05) respectively. Sixty two pts (88%)
had no or trivial MR and 9 pts (12%) had moderate MR (2+). There
were two late valve replacements for endocarditis and no late
deaths.
Conclusion: Port-Access MVR constitutes a valid alternative
to mid-sternotomy with good mid-term results.
|
