Clinical results of minimally invasive mitral valve surgery: endoaortic clamp versus external aortic clamp techniques

• Published in: Innovations (Philadelphia, Pa.) Pa.), 2009-11, Vol.4 (6), p.311-318
• Main Authors: Ius, Fabio, Mazzaro, Enzo, Tursi, Vincenzo, Guzzi, Giorgio, Spagna, Enrico, Vetrugno, Luigi, Bassi, Flavio, Livi, Ugolino
• Format: Article
• Language: English
• ISSN: 1556-9845; 1559-0879
• DOI: 10.1097/IMI.0b013e3181c490e5

: This study was carried out with the aim of presenting our experience with minimally invasive mitral surgery and compare the endoaortic clamp with the external aortic clamp (EAC) techniques. : Between December 2002 and May 2009, 139 patients (75 men, aged 63 ± 11 years) underwent video-assisted mitral valve surgery through right thoracotomy. Twelve (9%) patients were operated without clamping the aorta, 32 (23%) patients (group A) were operated on by using the endoaortic clamp, and 95 (68%) patients were operated on by using the EAC (group B). There was no significant difference between groups A and B regarding preoperative variables. : Intraoperative procedure-associated problems were experienced in three group A patients (9.3%, two aortic dissections with conversion to sternotomy; one conversion due to bad exposure) and in two group B patients (2%, one conversion to sternotomy for bleeding and one for ascending aorta hematoma). At a mean follow-up of 32 months, 121 patients (97%) were in New York Heart Association class I-II, with satisfactory echocardiographic results. There was one in-hospital and six late deaths (three noncardiac, two cardiac, and one valve related). Five-year actuarial survival was 88% ± 8%. There were three reoperations, one early (