Early Outcomes in Redo Minimal Invasive Mitral Valve Surgery Versus Redo Mitral Valve Surgery Through Median Full Sternotomy

Abstract

Background: Redo cardiac surgery with median resternotomy is surgically challenging because of the risk of injury to vital cardiac structures that are highly adherent under the sternum, such as the right ventricle, the ascending aorta, and a previously grafted coronary bypass. Minimally invasive techniques have been the trendiest choice for mitral valve surgery since the first publication by Carpentier and colleagues. Right-sided mini-thoracotomy has emerged as a feasible option to repeated regular median sternotomy for these patients because to its reduced invasiveness.

Objective: This research aims to examine the long-term effects of a less invasive kind of mitral valve surgery known as classic resternotomy on patients with mitral valve disease.

Patients and Methods: This prospective non randomized study included 50 Consecutive patients who needed redo mitral valve surgery in Armed Forces Hospitals divided in two groups according surgeon experience either minimally invasive surgery group (group A, n = 25) or operation through median resternotomy (group B, n = 25).

Results: As regards preoperative parameters, the two groups were comparable. There was no statistically significant difference in cross-clamp time or total bypass time, however there was a significant difference in overall operation time. There was significant difference in favor of group A in the intensive care parameters like the mechanical ventilation time, the blood loss, the blood transfusion the ICU stay, Total hospital and pain score

Conclusion: In an experienced minimally invasive surgical facility, redo mitral valve surgery may be done safely with a right anterolateral mini-thoracotomy, allowing better mitral valve vision and avoiding recurring sternotomy. After an initial learning curve, technological complexity improves patient outcomes.