Video-assisted thoracic surgical technique versus conventional surgical technique for mitral valve replacement: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Haiyu ,  WENG Guoxing , BAO Jiayin , XIE Qi , CHEN Zhiqun , WANG Huan , XIAO Rongdong

Department of Cardiovascular Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, P.R.China;

Corresponding?author：

WENG Guoxing, Email: gxw001@sina.com

Keywords：

Mitral valve replacement; video-assisted thoracoscopic surgery; cardiac surgery

DOI：

10.7507/1007-4848.201607030

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To compare video-assisted thoracic surgical technique (VATS) and conventional surgical technique (CSM) in mitral valve replacement (MVR). Methods We retrospectively analyzed clinical data of 93 patients in our hospital with mitral valve replacement between January 2010 and January 2015. The patients were divided into two groups including a VATS group and a CSM group.There were 43 patients with 25 males and 18 females at age of 57.43±5.65 years in the VATS group, and 50 patients with 27 males and 23 females at age of 56.40±6.32 years in the CSM group.The clinical outcomes of the two groups were compared. Results There was no mortality. Echocardiography was normal in both groups during 1-year follow-up. There was no significant difference between the two groups in the operative time, aortic clamping time, cardiopulmonary bypass (CPB) time, or ventilation time. As compared with the CSM group, the patients in the VATS group had a significantly lower complication rate, shorter chest incision length (5.23±1.36 cm vs. 18.21±3.89 cm), less blood transfusion (1.75±0.25 U vs. 3.15±1.50 U), less chest drainage (202.34±12.12 ml vs. 412.32±21.56 ml) and lower pain score (1.26±0.86 vs. 3.01±1.13), shorter time of postoperative hospital stay (8.20±2.36 d vs. 12.10±3.26 d). Conclusion MVR under VATS is not only technically feasible, but also with excellent clinical results.

Citation： CHEN Haiyu, WENG Guoxing, BAO Jiayin, XIE Qi, CHEN Zhiqun, WANG Huan, XIAO Rongdong. Video-assisted thoracic surgical technique versus conventional surgical technique for mitral valve replacement: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(9): 683-686. doi: 10.7507/1007-4848.201607030 Copy

1.	高長青, 楊明, 王剛, 等. 機器人微創二尖瓣置換術. 中華胸心血管外科雜志, 2011, 27(7): 390-392.
2.	高長青. 機器人微創心臟外科的發展及現狀. 中華胸心血管外科雜志, 2011, 27(7): 385-386.
3.	陳海宇, 翁國星, 陳智群, 等. 電視胸腔鏡輔助下房間隔缺損修補與常規手術比較研究. 福建醫藥雜志, 2010, 32 (3): 1-2.
4.	Carpentier A, Loulmet D, Carpentier A, et al. Open heart operation under videosurgery and minithoracotomy. First case(mitral valvuloplasty) operated with success. C R Acad Sci Ⅲ, 1996, 319(3): 219-223.
5.	Modi P, Hassan A, Chitwood WJ. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2008, 34(5): 943-952.
6.	賈寶成, 程云閣, 肖明第, 等. 不同方式二尖瓣置換術的臨床比較. 醫學研究雜志, 2011, 40(8): 55-56.
7.	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.
8.	肖明第, 程云閣. 微創心臟瓣膜外科的現狀與未來. 中國微創外科雜志, 2010, 10(2): 99-100.
9.	Murzi M, Cerillo AG, Miceli A, et al. Antegrade and retrograde arterial perfusion strategy in minimally invasive mitral-valve surgery: a propensity score analysis on 1280 patients. Eur J Cardiothorac Surg, 2013, 43(6): 167-172.
10.	魏來, 王春生, 沈金強, 等. Chitwood 法微創心臟瓣膜手術 115 例臨床分析. 中華外科雜志, 2011, 49(4): 373-375.
11.	Botta L, Cannata A, Bruschi G, et al. Minimally invasive approach for redo mitral valve surgery. J Thorac Dis, 2013, 5(Suppl 6): S686-S693.
12.	Santana O, Reyna J, Grana R, et al. Outcomes of minimally invasive valve surgery versus standard sternotomy in obese patients undergoing isolated valve surgery. Ann Thorac Surg, 2011, 91(2): 406-410.
13.	Kim DC, Chee HK, Song MG, et al. Comparative analysis of thoracotomy and sternotomy approaches in cardiac reoperation. Korean J Thorae Cardiovasc Surg, 2012, 45(4): 225-229.
14.	Cohn LH, Byrne JG. Minimally invasive mitral valve surgery: current status. Tex Heart Inst J, 2013, 40(5): 575-576.
15.	Suri RM, Thalji NM. Minimally invasive heart valve surgery: how and why in 2012. Curr Cardiol Rep, 2012, 14(2): 171-179.
16.	張偉華, 李杰, 張新, 等. GK 雙葉機械瓣應用于二尖瓣置換術機械功能評價的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(10): 965-968.
17.	師恩祎, 谷天祥, 喻磊, 等. 微創與常規二尖瓣成形和置換術治療單純二尖瓣病變患者的病例對照研究. 中國胸心血管外科臨床雜志, 2013, 20(10): 294.
18.	陳波, 郭惠明. 微創胸腔鏡與傳統正中開胸二尖瓣手術效果比較的進展. 中國胸心血管外科臨床雜志, 2016, 23(10): 1006-1011.
19.	Grossi EA, Loulmet DF, Schwartz CF, et al. Evolution of operative techniques and perfusion strategies for minimally invasive mitral valve repair. J Thorac Cardiovasc Surg, 2012, 143(4): 68-70.
20.	Holzhey DM, Seeburger J, Misfeld M, et al. Learning minimally operations from a single high-volume center. Circulation, 2013, 128(5): 483-491.
21.	Raanani E, Spiegelstein D, Sternik L, et al. Quality of mitral valve repair; median sternotomy versus port-access approach. J Thorac Cardiovasc Surg, 2010, 140(1): 86-90.

1. 高長青, 楊明, 王剛, 等. 機器人微創二尖瓣置換術. 中華胸心血管外科雜志, 2011, 27(7): 390-392.
2. 高長青. 機器人微創心臟外科的發展及現狀. 中華胸心血管外科雜志, 2011, 27(7): 385-386.
3. 陳海宇, 翁國星, 陳智群, 等. 電視胸腔鏡輔助下房間隔缺損修補與常規手術比較研究. 福建醫藥雜志, 2010, 32 (3): 1-2.
4. Carpentier A, Loulmet D, Carpentier A, et al. Open heart operation under videosurgery and minithoracotomy. First case(mitral valvuloplasty) operated with success. C R Acad Sci Ⅲ, 1996, 319(3): 219-223.
5. Modi P, Hassan A, Chitwood WJ. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2008, 34(5): 943-952.
6. 賈寶成, 程云閣, 肖明第, 等. 不同方式二尖瓣置換術的臨床比較. 醫學研究雜志, 2011, 40(8): 55-56.
7. 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.
8. 肖明第, 程云閣. 微創心臟瓣膜外科的現狀與未來. 中國微創外科雜志, 2010, 10(2): 99-100.
9. Murzi M, Cerillo AG, Miceli A, et al. Antegrade and retrograde arterial perfusion strategy in minimally invasive mitral-valve surgery: a propensity score analysis on 1280 patients. Eur J Cardiothorac Surg, 2013, 43(6): 167-172.
10. 魏來, 王春生, 沈金強, 等. Chitwood 法微創心臟瓣膜手術 115 例臨床分析. 中華外科雜志, 2011, 49(4): 373-375.
11. Botta L, Cannata A, Bruschi G, et al. Minimally invasive approach for redo mitral valve surgery. J Thorac Dis, 2013, 5(Suppl 6): S686-S693.
12. Santana O, Reyna J, Grana R, et al. Outcomes of minimally invasive valve surgery versus standard sternotomy in obese patients undergoing isolated valve surgery. Ann Thorac Surg, 2011, 91(2): 406-410.
13. Kim DC, Chee HK, Song MG, et al. Comparative analysis of thoracotomy and sternotomy approaches in cardiac reoperation. Korean J Thorae Cardiovasc Surg, 2012, 45(4): 225-229.
14. Cohn LH, Byrne JG. Minimally invasive mitral valve surgery: current status. Tex Heart Inst J, 2013, 40(5): 575-576.
15. Suri RM, Thalji NM. Minimally invasive heart valve surgery: how and why in 2012. Curr Cardiol Rep, 2012, 14(2): 171-179.
16. 張偉華, 李杰, 張新, 等. GK 雙葉機械瓣應用于二尖瓣置換術機械功能評價的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(10): 965-968.
17. 師恩祎, 谷天祥, 喻磊, 等. 微創與常規二尖瓣成形和置換術治療單純二尖瓣病變患者的病例對照研究. 中國胸心血管外科臨床雜志, 2013, 20(10): 294.
18. 陳波, 郭惠明. 微創胸腔鏡與傳統正中開胸二尖瓣手術效果比較的進展. 中國胸心血管外科臨床雜志, 2016, 23(10): 1006-1011.
19. Grossi EA, Loulmet DF, Schwartz CF, et al. Evolution of operative techniques and perfusion strategies for minimally invasive mitral valve repair. J Thorac Cardiovasc Surg, 2012, 143(4): 68-70.
20. Holzhey DM, Seeburger J, Misfeld M, et al. Learning minimally operations from a single high-volume center. Circulation, 2013, 128(5): 483-491.
21. Raanani E, Spiegelstein D, Sternik L, et al. Quality of mitral valve repair; median sternotomy versus port-access approach. J Thorac Cardiovasc Surg, 2010, 140(1): 86-90.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Video-assisted thoracic surgical technique versus conventional surgical technique for mitral valve replacement: A case control study

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