Video-assisted Thoracoscopic Surgery for Bioprosthetic Mitral Valve Replacement in 32 Patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUJian ,  GUOHui-ming , XIEBin , ZHANGXiao-shen , HUANGHuan-lei , LUCong , LIUJing , ZHUANGJian

Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China;

Corresponding author：

GUOHui-ming, Email: guohuiming@vip.tom.com

Keywords：

Video-assisted thoracoscopic surgery; Mitral valve replacement; Bioprosthesis

DOI：

10.7507/1007-4848.20140167

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze clinical experience and outcomes of video-assisted thoracoscopic surgery (VATS)for bioprosthetic mitral valve replacement (MVR). Methods We retrospectively analyzed 32 patients who underwent VATS bioprosthetic MVR in the Department of Cardiovascular Surgery of Guangdong General Hospital from March to December 2013. There were 14 males and 18 females with a mean age of 55.6±17.3 years (range, 19 to 80 years), mean body weight of 55.7±9.7 kg (range, 37 to 78 kg) and mean body surface area of 1.67±0.16 m² (range, 1.30 to 1.95 m²). Five patients had atrial fibrillation. There were 20 patients in New York Heart Association (NYHA)functional class Ⅱ, 11 patients in class Ⅲ, and 1 patient in class Ⅳ. There were 16 patients with rheumatic mitral valve disease, 11 patients with degenerative mitral valve disease, 4 patients with infective endocarditis and 1 patient with associated congenital heart disease. Results VATS bioprosthetic MVR was successfully performed for all the patients, including 27 patients with Medtronic Hancock Ⅱ Bioprosthesis and 5 patients with Medtronic Mosaic Bioprosthesis. Concomitantly, tricuspid valvuloplasty was performed for 13 patients and atrial septal defect repair was performed for 1 patient. There was no in-hospital death, low cardiac output syndrome or left ventricular rupture. Postoperative echocardiography showed good bioprosthetic function in all the patients without paravalvular leakage. Postoperative cardiac function significantly improved compared with preoperative cardiac function. There were 9 patients in NYHA functional class Ⅰ, 17 patients in class Ⅱ, and 6 patients in class Ⅲ. Left atrial diameter and left ventricular end-diastolic diameter examined postoperatively and 3 months after surgery were significantly smaller than preoperative values. Left ventricular ejection fraction (LVEF)examined postoperatively and 3 months after surgery was significantly lower than preoperative LVEF. Conclusions VATS bioprosthetic MVR is a minimally invasive, safe and feasible procedure with a low postoperative morbidity. Incision size can be significantly reduced with a special type of bioprosthesis.

Citation： LIUJian, GUOHui-ming, XIEBin, ZHANGXiao-shen, HUANGHuan-lei, LUCong, LIUJing, ZHUANGJian. Video-assisted Thoracoscopic Surgery for Bioprosthetic Mitral Valve Replacement in 32 Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 582-586. doi: 10.7507/1007-4848.20140167 Copy

1.	Vollroth M, Seeburger J, Garbade J, et al. Minimally invasive mitral valve surgery is a very safe procedure with very low rates of conversion to full sternotomy. Eur J Cardiothorac Surg, 2012, 42(1):e13-e15.
2.	金海, 徐志云, 于伟勇, 等.微创小切口心脏瓣膜手术134例.中国胸心血管外科临床杂志, 2005, 12(4):237-239.
3.	Granov N, Kacila M, Solinas M, et al. Minimally invasive mitral valve surgery through right lateral minithoracotomy--early experience of clinical centre of university of sarajevo. Med Arh, 2012, 66(5):357-358.
4.	Chitwood WR, Elbeery JR, Moran JF. Minimally invasive mitral valve repair using transthoracic aortic occlusion. Ann Thorac Surg, 1997, 63(5):1477-1479.
5.	Aybek T, Dogan S, Wimmer-Greinecker G, et al. The micro-mitral operation comparing the Port-Access technique and the transthoracic clamp technique. J Card Surg, 2001, 15(1):76-81.
6.	Jegaden O, Sassard T, Shafy A, et al. Evaluation of a new left atrial retractor for minimally invasive mitral valve surgery. J Thorac Cardiovasc Surg, 2011, 141(1):297-299.
7.	Murzi M, Solinas M, Bevilacqua S, et al. A new left atrial retractor for minimally invasive mitral valve surgery. J Card Surg, 2009, 24(2):175-177.
8.	Coosemans W, Lerut TE, Van Raemdonck D E. Thoracoscopic surgery:the belgian experience. Ann Thorac Surg, 1993, 56(3):721-730.
9.	Dogan S, Aybek T, Risteski PS, et al. Minimally invasive port access versus conventional mitral valve surgery:prospective randomized study. Ann Thorac Surg, 2005, 79(2):492-498.
10.	Iribarne A, Karpenko A, Russo MJ, et al. Eight-year experience with minimally invasive cardiothoracic surgery. World J Surg, 2010, 34(4):611-615.
11.	魏来, 王春生, 沈金强, 等. Chitwood法微创心脏瓣膜手术115例临床分析.中华外科杂志, 2011, 49(4):373-375.
12.	Liu X, Wu Y, Zhu J, et al. Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients. Eur J Med Res, 2014, 19:13.
13.	Sadler L, Mccowan L, White H, et al. Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves. BJOG, 2000, 107(2):245-253.
14.	El Oakley R, Kleine P, Bach DS. Choice of prosthetic heart valve in today's practice. Circulation, 2008, 117(2):253-256.
15.	Kaneko Y, Kohno T, Ohtsuka T, et al. Video-assisted observation in mitral valve surgery. J Thorac Cardiovasc Surg, 1996, 111(1):279-280.
16.	王潇, 陶凉, 陈绪发, 等.右胸微创小切口二尖瓣置换术与传统二尖瓣置换术的对比分析.中国胸心血管外科临床杂志, 2013, 20(2):139-143.
17.	Cheng DC, Martin J, Lal A, et al. Minimally invasive versus conven-tional open mitral valve surgery:a meta-analysis and systematic review. Innovations (Phila), 2011, 6(2):84-103.
18.	Mihos CG, Santana O, Lamas GA, et al. Incidence of postoperative atrial fibrillation in patients undergoing minimally invasive versus median sternotomy valve surgery. J Thorac Cardiovasc Surg, 2013, 146(6):1436-1441.
19.	Chen X, Sun D, Yang J, et al. Preoperative assessment of mitral valve prolapse and chordae rupture using real time three-dimensional transesophageal echocardiography. Echocardiography, 2011, 28(9):1003-1010.
20.	Akiyama K, Arisawa S, Ide M, et al. Intraoperative cardiac assessment with transesophageal echocardiography for decision-making in cardiac anesthesia. Gen Thorac Cardiovasc Surg, 2013, 61(6):320-329.
21.	Ma ZS, Yin QY, Dong MF, et al. Quality of life in patients undergoing totally thoracoscopic closure for atrial septal defect. Ann Thorac Surg, 2011, 92(6):2230-2234.

1. Vollroth M, Seeburger J, Garbade J, et al. Minimally invasive mitral valve surgery is a very safe procedure with very low rates of conversion to full sternotomy. Eur J Cardiothorac Surg, 2012, 42(1):e13-e15.
2. 金海, 徐志云, 于伟勇, 等.微创小切口心脏瓣膜手术134例.中国胸心血管外科临床杂志, 2005, 12(4):237-239.
3. Granov N, Kacila M, Solinas M, et al. Minimally invasive mitral valve surgery through right lateral minithoracotomy--early experience of clinical centre of university of sarajevo. Med Arh, 2012, 66(5):357-358.
4. Chitwood WR, Elbeery JR, Moran JF. Minimally invasive mitral valve repair using transthoracic aortic occlusion. Ann Thorac Surg, 1997, 63(5):1477-1479.
5. Aybek T, Dogan S, Wimmer-Greinecker G, et al. The micro-mitral operation comparing the Port-Access technique and the transthoracic clamp technique. J Card Surg, 2001, 15(1):76-81.
6. Jegaden O, Sassard T, Shafy A, et al. Evaluation of a new left atrial retractor for minimally invasive mitral valve surgery. J Thorac Cardiovasc Surg, 2011, 141(1):297-299.
7. Murzi M, Solinas M, Bevilacqua S, et al. A new left atrial retractor for minimally invasive mitral valve surgery. J Card Surg, 2009, 24(2):175-177.
8. Coosemans W, Lerut TE, Van Raemdonck D E. Thoracoscopic surgery:the belgian experience. Ann Thorac Surg, 1993, 56(3):721-730.
9. Dogan S, Aybek T, Risteski PS, et al. Minimally invasive port access versus conventional mitral valve surgery:prospective randomized study. Ann Thorac Surg, 2005, 79(2):492-498.
10. Iribarne A, Karpenko A, Russo MJ, et al. Eight-year experience with minimally invasive cardiothoracic surgery. World J Surg, 2010, 34(4):611-615.
11. 魏来, 王春生, 沈金强, 等. Chitwood法微创心脏瓣膜手术115例临床分析.中华外科杂志, 2011, 49(4):373-375.
12. Liu X, Wu Y, Zhu J, et al. Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients. Eur J Med Res, 2014, 19:13.
13. Sadler L, Mccowan L, White H, et al. Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves. BJOG, 2000, 107(2):245-253.
14. El Oakley R, Kleine P, Bach DS. Choice of prosthetic heart valve in today's practice. Circulation, 2008, 117(2):253-256.
15. Kaneko Y, Kohno T, Ohtsuka T, et al. Video-assisted observation in mitral valve surgery. J Thorac Cardiovasc Surg, 1996, 111(1):279-280.
16. 王潇, 陶凉, 陈绪发, 等.右胸微创小切口二尖瓣置换术与传统二尖瓣置换术的对比分析.中国胸心血管外科临床杂志, 2013, 20(2):139-143.
17. Cheng DC, Martin J, Lal A, et al. Minimally invasive versus conven-tional open mitral valve surgery:a meta-analysis and systematic review. Innovations (Phila), 2011, 6(2):84-103.
18. Mihos CG, Santana O, Lamas GA, et al. Incidence of postoperative atrial fibrillation in patients undergoing minimally invasive versus median sternotomy valve surgery. J Thorac Cardiovasc Surg, 2013, 146(6):1436-1441.
19. Chen X, Sun D, Yang J, et al. Preoperative assessment of mitral valve prolapse and chordae rupture using real time three-dimensional transesophageal echocardiography. Echocardiography, 2011, 28(9):1003-1010.
20. Akiyama K, Arisawa S, Ide M, et al. Intraoperative cardiac assessment with transesophageal echocardiography for decision-making in cardiac anesthesia. Gen Thorac Cardiovasc Surg, 2013, 61(6):320-329.
21. Ma ZS, Yin QY, Dong MF, et al. Quality of life in patients undergoing totally thoracoscopic closure for atrial septal defect. Ann Thorac Surg, 2011, 92(6):2230-2234.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Video-assisted Thoracoscopic Surgery for Bioprosthetic Mitral Valve Replacement in 32 Patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content