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| Format: | Artículo científico |
| Langue: | en |
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Sociedad Argentina de Cardiología
2017
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| Accès en ligne: | https://www.redalyc.org/articulo.oa?id=305353992005 |
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- Is Minimally Invasive Mitral Valve Surgery Possible in Complex Patients? GERMÁN A. FORTUNATO MATÍAS N. RÍOS ROBERTO BATTELLINI MARCELO HALAC TORSTEN DOENST VADIM KOTOWICZ Medicina Video assisted Reoperation Minimally invasive Mitral valve repair Background: Patients at high risk of preoperative morbidity and mortality, mitral valve endocarditis or prior cardiac surgery are considered “limiting” cases to undergo minimally invasive cardiac surgery. Objectives: The aim of this study was to assess the outcome of complex patients undergoing minimally invasive surgery. The primary endpoint was post-operative mortality at 30 days and the secondary endpoint was the analysis of technical-surgical results and early postoperative complications. Methods: The study consisted in the retrospective analysis of mitral valve surgeries performed at Hospital Italiano de Buenos Aires from January 2010 to April 2016. A total of 135 mitral valve surgeries, 63 by minimally invasive technique (46.6%) were performed. Forty-five patients (71.4%) were considered as “complex”, including those with >10% STS-PROMM risk, active endocarditis, or prior cardiac surgery. Results: Surgeries were elective in 73.3% of cases (n=33), urgent in 22.2% (n=10) and emergent in 4.4% (n=2). Percent STS-PROM and %STS-PROMM were 6.08±10.8 and 26.7±16.8, respectively. Six patients with prior cardiac surgery and 5 with endocarditis in active treatment were included. Mitral valve replacement (14 rheumatic) was performed in 62% of patients (n=28) and mitral valve repair in 38% (n=17). No deaths were registered in mitral valve repair or mediastinitis. Mortality at 30 days was 4.4% (n=2) and conversion to sternotomy was necessary in one case. Conclusions: The observed mortality is lower than the one calculated by the risk score (%STS-PROMM 6.08±10.8 vs. 4.4). The right video-assisted minithoracotomy offered excellent exposure and interpretation of the disease. The minimally invasive surgical technique can be used in patients with prior cardiac surgery, endocarditis and/or patients with a high preoperative risk score. 2017 artículo científico 0034-7000 https://www.redalyc.org/articulo.oa?id=305353992005 en http://www.redalyc.org/revista.oa?id=3053 Revista Argentina de Cardiología application/pdf Sociedad Argentina de Cardiología Revista Argentina de Cardiología (Argentina) Num.4 Vol.85