A comparative study of mitral valve replacement by right 3rd intercostal small incision and traditional median thoracotomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GAO Yang ,  QIAO Yanli , CHEN Qingwei , CHEN Guoqing , YAN Lei

Department of Cardiovascular Surgery, Affiliated Hospital of Jining Medical College, Jining, 272029, Shandong, P.R.China;

Corresponding author：

QIAO Yanli, Email: yanliq802@aliyun.com

Keywords：

Mitral valve replacement; later thoracotomy; median thoracotomy

DOI：

10.7507/1007-4848.201903028

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the safety and efficacy of simple mitral valve replacement with the third intercostal incision on the right side and the conventional midsternum incision.Methods From February 2017 to February 2019, heart surgery in the Affiliated Hospital of Jining Medical College completed the first simple mitral valve replacement (MVR) operation in 103 patients, of whom 39 patients were received minimally invasive right third intercostal small incision (a minimally invasive surgery group). There were 10 males, 29 females at average age of 59.51 years. There were 64 patients with MVR via the middle section of the common sternum (a conventional surgery group), 22 males and 42 females, with an average age of 60.22 years. Types of lesions: 65 patients were with mitral stenosis, 22 patients with incomplete closure, 16 patients with incomplete closure.Results There was no significant difference in preoperative clinical data between the two groups (P>0.05). The entire group of patients successfully completed the operation. Surgical replacement of mitral valve mechanical valve in 74 patients and biological valve in 29 patients. There was no significant difference between the two groups in the extracardiopulmonary cycle time, aortic blockade time and total hospitalization time. In the early stage of operation, 3 patients were examined for secondary hemostasis, 1 patient was minimally invasive surgery, and the remaining 2 patients were with routine surgery. The infection of incision occurred in 3 patients, all of them were in the routine operation group. All three patients died early after operation in the routine operation group: two were postoperative low cardiac volumetric syndrome leading to multiple organ failure, and the other was sternum infection accompanied by artificial valve endocarditis.Conclusion There is no significant difference between MVR through the third rib of the right chest and traditional MVR in the safety. However, it has the advantages of small trauma, beauty, low incidence of incision infection and reduced postoperative pain.

Citation： GAO Yang, QIAO Yanli, CHEN Qingwei, CHEN Guoqing, YAN Lei. A comparative study of mitral valve replacement by right 3rd intercostal small incision and traditional median thoracotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1204-1207. doi: 10.7507/1007-4848.201903028 Copy

1.	Iribarne A, Easterwood R, Chan EY, et al. The golden age of minimally invasive cardiothoracic surgery: current and future perspective. Future Cardiol, 2011, 7: 333-346.
2.	Fortunato Junior JA, Fernandes AG, Sesca JR, et al. Minimally in vasive aortic valve replacement: an alternative to the conventional technique. Rev Bras Cir Cardiovasc, 2012, 27(4): 570-582.
3.	王齐敏, 陈道中, 方冠华, 等. 胸腔镜辅助右胸小切口二尖瓣置换术(附 45 例报告). 中国微创外科杂志, 2013, 13(10): 944-945.
4.	Bouhout I, Morgant MC, Bouchard D. Minimally invasive heart valve surger. Can J Cardiol, 2017, 33(9): 1129-1137.
5.	Easterwood RM, Bostock IC, Nammalwar S, et al. The evolution of minimally invasive cardiac surgery: from minimal access to transcatheter approaches. Future Cardiol, 2018, 14(1): 75-87.
6.	Mazine A, Vistarini N, Ghoneim A, et al. Very high repair rate using minimally invasive surgery for the treatment of degenerative mitral in sufficiency. Can J Cardiol, 2015, 31: 744-751.
7.	吴永兵, 周建良, 张小强, 等. 电视胸腔镜辅助下微创二尖瓣手术 42 例. 江西医药, 2012, 47(4): 289-291.
8.	王潇, 陶良, 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(4): 139-141.
9.	乔衍礼, 安国营, 张洪宇, 等. 右腋下小切口体外循环心内直视手术 270 例. 中国胸心血管外科临床杂志, 2012, 19(5): 565-566.
10.	乔衍礼, 倪良春, 郑善光, 等. 完全电视胸腔镜下心脏手术 108 例. 中华胸心血管外科杂志, 2012, 28(4): 207-208.
11.	Qiao Y, An G, Chen G, et al. Minimally invasive video-assisted double-valve replacement through right anterolateral minithoracotomy. Heart Lung Circ, 2014, 23(9): 847-851.
12.	Pojar M, Vojacek J, Karalko M, et al. Single-center experience with minimally invasive mitral operations through right minithoracotomy. Ann Thorac Cardiovasc Surg, 2019, 25(1): 18-25.
13.	尤斌, 高峰, 李平, 等. 保持胸廓完整性的右前外胸部小切口手术治疗心脏多瓣膜病变. 中国微创外科杂志, 2013, 13(5): 452-454.
14.	Wang Q, Xue X, Yang J, et al. Right mini-thoracotomy approach reduces hospital stay and transfusion of mitral or tricuspid valve reoperation with non-inferior efficacy: evidence from propensity-matched study. J Thorac Dis, 2018, 10(8): 4789-4800.
15.	张致琦, 赵东, 朱仕杰, 等. 12 例右胸骨旁第 3 肋间小切口行三瓣膜手术的临床经验. 复旦学报 (医学版), 2015, 42(2): 222-225.
16.	王东进, 武忠, 曹彬, 等. 右腋下小切口二尖瓣、主动脉瓣双瓣膜置换术 28 例. 中国胸心血管外科临床杂志, 2004, 11(4): 295-297.

1. Iribarne A, Easterwood R, Chan EY, et al. The golden age of minimally invasive cardiothoracic surgery: current and future perspective. Future Cardiol, 2011, 7: 333-346.
2. Fortunato Junior JA, Fernandes AG, Sesca JR, et al. Minimally in vasive aortic valve replacement: an alternative to the conventional technique. Rev Bras Cir Cardiovasc, 2012, 27(4): 570-582.
3. 王齐敏, 陈道中, 方冠华, 等. 胸腔镜辅助右胸小切口二尖瓣置换术(附 45 例报告). 中国微创外科杂志, 2013, 13(10): 944-945.
4. Bouhout I, Morgant MC, Bouchard D. Minimally invasive heart valve surger. Can J Cardiol, 2017, 33(9): 1129-1137.
5. Easterwood RM, Bostock IC, Nammalwar S, et al. The evolution of minimally invasive cardiac surgery: from minimal access to transcatheter approaches. Future Cardiol, 2018, 14(1): 75-87.
6. Mazine A, Vistarini N, Ghoneim A, et al. Very high repair rate using minimally invasive surgery for the treatment of degenerative mitral in sufficiency. Can J Cardiol, 2015, 31: 744-751.
7. 吴永兵, 周建良, 张小强, 等. 电视胸腔镜辅助下微创二尖瓣手术 42 例. 江西医药, 2012, 47(4): 289-291.
8. 王潇, 陶良, 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(4): 139-141.
9. 乔衍礼, 安国营, 张洪宇, 等. 右腋下小切口体外循环心内直视手术 270 例. 中国胸心血管外科临床杂志, 2012, 19(5): 565-566.
10. 乔衍礼, 倪良春, 郑善光, 等. 完全电视胸腔镜下心脏手术 108 例. 中华胸心血管外科杂志, 2012, 28(4): 207-208.
11. Qiao Y, An G, Chen G, et al. Minimally invasive video-assisted double-valve replacement through right anterolateral minithoracotomy. Heart Lung Circ, 2014, 23(9): 847-851.
12. Pojar M, Vojacek J, Karalko M, et al. Single-center experience with minimally invasive mitral operations through right minithoracotomy. Ann Thorac Cardiovasc Surg, 2019, 25(1): 18-25.
13. 尤斌, 高峰, 李平, 等. 保持胸廓完整性的右前外胸部小切口手术治疗心脏多瓣膜病变. 中国微创外科杂志, 2013, 13(5): 452-454.
14. Wang Q, Xue X, Yang J, et al. Right mini-thoracotomy approach reduces hospital stay and transfusion of mitral or tricuspid valve reoperation with non-inferior efficacy: evidence from propensity-matched study. J Thorac Dis, 2018, 10(8): 4789-4800.
15. 张致琦, 赵东, 朱仕杰, 等. 12 例右胸骨旁第 3 肋间小切口行三瓣膜手术的临床经验. 复旦学报 (医学版), 2015, 42(2): 222-225.
16. 王东进, 武忠, 曹彬, 等. 右腋下小切口二尖瓣、主动脉瓣双瓣膜置换术 28 例. 中国胸心血管外科临床杂志, 2004, 11(4): 295-297.

Previous Article
Risk factors of new atrial fibrillation after coronary artery bypass grafting
Next Article
Efficacy and safety of ultrasound-guided percutaneous retrograde closure of patent ductus arteriosus

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

A comparative study of mitral valve replacement by right 3rd intercostal small incision and traditional median thoracotomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content