In-Hospital Outcomes of Right Minithoracotomy vs. Periareolar Access for Minimally Invasive Video-Assisted Mitral Valve Repair


Brazilian Journal of Cardiovascular Surgery




Abstract Introduction: In minimally invasive mitral valve repair, right minithoracotomy is the most widely performed method, providing a good view of the mitral valve. But regarding other techniques and although it offers limited visualization, the periareolar access is a less traumatic alternative. This study’s purpose is to compare in-hospital outcomes in patients who underwent video-assisted minimally invasive mitral valve repair via right minithoracotomy and periareolar access. Methods: This is a retrospective observational study including 37 patients (> 18 years old), without previous right thoracic surgery, who underwent their primary mitral valve repair, with indication for minimally invasive video-assisted approach (via right minithoracotomy or periareolar access), between January 2018 and August 2019. Patients’ medical records were consulted to collect demographics data, operative details, and in-hospital outcomes. Results: Twenty-one patients underwent right minithoracotomy, and 16 were operated via periareolar access. The mean patients’ age was 62±12 years in the right minithoracotomy group and 61±9 years in the periareolar access group (P=0.2). There are no significant differences in incision length, cardiopulmonary bypass time, aortic cross-clamping time, hematocrit, amount of chest tube drainage, and intensive care unit and in-hospital length of stay. Time to extubation presented significant differences between the right minithoracotomy and the periareolar access group (4.85 hours vs. 5.62 hours, respectively) (P=0.04). Conclusion: In this study, we found similar results in the two applied surgical techniques, except for the time to extubation.

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