Early and mid-term results of minimally invasive video-assisted mitral valve replacement via right thoracotomy at Bach Mai hospital

Pham Quoc Dat, Duong Duc Hung, Nguyen Huu Uoc

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Abstract

Objective: The study aimed to evaluate the early and mid-term results of minimally invasive video-assisted mitral valve replacement surgery at Bach Mai Hospital.


Methods: A descriptive study. Including 106 patients from January 2018 to December 2020 with a follow-up period of at least six months.


Result: Mean age was 50.5 ± 10.5; Rate of female was 64.2%; pre-operative NYHA III-IV class in 53 (50.0%) cases; LVEF less than 50% in 3 (2.8%) cases; Pulmonary artery hypertension (over 65 mmHg) in 14 (13.2%) cases. The pathogenesis of rheumatic heart disease, degeneration, and endocarditis accounted for 75.5%, respectively; 14.1%; and 10.4%. The cardiopulmonary bypass time and the cross-clamp time is 95.1 minutes and 63.2 minutes, respectively. The factors related to the cardiopulmonary bypass time and the cross-clamp time were tricuspid valve repair and mitral valve replacement by continuous suture technique. Early mortality was 0.9%, rate of conversion to sternotomy was 0.9%. The mechanical ventilation time, length of ICU stay, and length of hospital stay were 16.8 hours, 48.0 hours, and 10.5 days, respectively. Factors that influence the severe complications include endocarditis, severe pulmonary hypertension, moderate/severe tricuspid regurgitation, and under-weight. Mid-term follow-up was on 105 patients with a mean duration of 17.9 months. The mid-term mortality was 1.0%, the re-operative rate was 3.8%.


Conclusion: Minimally invasive video-assisted mitral valve replacement surgery through right thoracotomy is a safe method with possible short- and mid-term results.

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References

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