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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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.	高长青, 杨明, 王刚, 等. 机器人微创二尖瓣置换术. 中华胸心血管外科杂志, 2011, 27(7): 390-392.
2.	高长青. 机器人微创心脏外科的发展及现状. 中华胸心血管外科杂志, 2011, 27(7): 385-386.
3.	陈海宇, 翁国星, 陈智群, 等. 电视胸腔镜辅助下房间隔缺损修补与常规手术比较研究. 福建医药杂志, 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.	贾宝成, 程云阁, 肖明第, 等. 不同方式二尖瓣置换术的临床比较. 医学研究杂志, 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, 程云阁. 微创心脏瓣膜外科的现状与未来. 中国微创外科杂志, 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.
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.	张伟华, 李杰, 张新, 等. GK 双叶机械瓣应用于二尖瓣置换术机械功能评价的病例对照研究. 中国胸心血管外科临床杂志, 2016, 23(10): 965-968.
17.	师恩祎, 谷天祥, 喻磊, 等. 微创与常规二尖瓣成形和置换术治疗单纯二尖瓣病变患者的病例对照研究. 中国胸心血管外科临床杂志, 2013, 20(10): 294.
18.	陈波, 郭惠明. 微创胸腔镜与传统正中开胸二尖瓣手术效果比较的进展. 中国胸心血管外科临床杂志, 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. 高长青, 杨明, 王刚, 等. 机器人微创二尖瓣置换术. 中华胸心血管外科杂志, 2011, 27(7): 390-392.
2. 高长青. 机器人微创心脏外科的发展及现状. 中华胸心血管外科杂志, 2011, 27(7): 385-386.
3. 陈海宇, 翁国星, 陈智群, 等. 电视胸腔镜辅助下房间隔缺损修补与常规手术比较研究. 福建医药杂志, 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. 贾宝成, 程云阁, 肖明第, 等. 不同方式二尖瓣置换术的临床比较. 医学研究杂志, 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, 程云阁. 微创心脏瓣膜外科的现状与未来. 中国微创外科杂志, 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.
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. 张伟华, 李杰, 张新, 等. GK 双叶机械瓣应用于二尖瓣置换术机械功能评价的病例对照研究. 中国胸心血管外科临床杂志, 2016, 23(10): 965-968.
17. 师恩祎, 谷天祥, 喻磊, 等. 微创与常规二尖瓣成形和置换术治疗单纯二尖瓣病变患者的病例对照研究. 中国胸心血管外科临床杂志, 2013, 20(10): 294.
18. 陈波, 郭惠明. 微创胸腔镜与传统正中开胸二尖瓣手术效果比较的进展. 中国胸心血管外科临床杂志, 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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