Surgery of Two or More Heart Valves through a Mini-access

Sergei Makeev, Igor Chernov, Dmitry Kozmin, Soslan Enginoev, Gasan Magomedov, Dmitry Tarasov

The federal center of cardiovascular surgery Astrakhan, Astrakhan, Russia

Date, time and location: 2018.05.26 17:00, Exhibition area, 1st Floor. Zone – C

Abstract

The goal of the study: to determine the possibilities of minimally invasive surgery on the basis of a retrospective analysis of the direct results of surgical treatment of patients who undergo surgery on two or more heart valves through a mini-access.

Materials and methods: From October 2013 to October 2017, multivalve correction via mini-access was performed by 30 patients. The average age is 58.3 ± 5.5 years. The study group included 12 men, 18 women. NYHA class II - 3, III - 24, IV - 3 patients. Etiology: chronic rheumatic heart disease - 15, connective tissue dysplasia - 13, infectious endocarditis - 1, hypertrophic cardiomyopathy - 1 patient. Concomitant pathology: arterial hypertension - 7, obesity - 9, stroke in history - 1, atrial fibrillation - 15 patients. Mini-thoracotomy was used in 13 patients and partial sternotomy in 17 patients. In 1 case a conversion occurred.

Results. The operation time was 218 ± 49 minutes, the time of time of artificial circulation was 137 ± 35.8 min. The time of myocardial ischemia was 103.6 ± 27.1 min. In 1 case there was a relapse of mitral insufficiency. The volume of postoperative blood loss was 363.3 ± 54.9 ml. Early postoperative complications: perioperative myocardial infarction-1; multiorgan failure - 1; stroke - 1; implantation of a pacemaker - 2; supraventricular tachycardia, requiring ablation - 1; hemopericardium, requiring drainage - 3; puncture of the pleural cavity for hemothorax - 1; bilateral nosocomial pneumonia - 1; delirium-1. A whole uncomplicated postoperative period was noted in 19 patients. The period of hospitalization was 12.2 ± 4.8 days. Mortality - 2 patients.

Conclusions. Minimally invasive techniques provide good visualization and allow performing a wide range of manipulations on the valvular heart apparatus.