Minimally invasive approach compared to resternotomy for mitral valve surgery in patients with prior cardiac surgery
| Autor: | Olsthoorn, Jules R., Heuts, Samuel, Houterman, Saskia, Maessen, Jos G., Sardari Nia, Peyman, Bramer, S., van Boven, W. J. P., Vonk, A. B. A., Koene, B. M. J. A., Bekkers, J. A., Hoohenkerk, G. J. F., Markou, A. L. P., de Weger, A., Segers, P., Porta, F., Speekenbrink, R. G. H., Stooker, W., Li, W. W. L., Daeter, E. J., van der Kaaij, N. P., Douglas, Y. |
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| Přispěvatelé: | CTC, MUMC+: MA Med Staf Artsass CTC (9), RS: Carim - Vessels, MUMC+: MA Cardiothoracale Chirurgie (3), RS: Carim - V04 Surgical intervention, MUMC+: MA Med Staf Spec CTC (9), Cardio-thoracic surgery, ACS - Atherosclerosis & ischemic syndromes, ACS - Heart failure & arrhythmias, ACS - Microcirculation, Cardiothoracic Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
Reoperation Mitral valve surgery Mitral Valve Insufficiency General Medicine Resternotomy Sternotomy Nationwide registry Treatment Outcome Minimally invasive mitral valve surgery Humans Minimally Invasive Surgical Procedures Mitral Valve Surgery Cardiac Surgical Procedures Cardiology and Cardiovascular Medicine Netherlands Retrospective Studies |
| Zdroj: | European Journal of Cardio-Thoracic Surgery, 62(5):ezac420. Oxford University Press European Journal of Cardio-thoracic Surgery, 62(5):ezac420. Elsevier European journal of cardio-thoracic surgery, 62(5):ezac420. Elsevier Olsthoorn, J R, Heuts, S, Houterman, S, Maessen, J G, Sardari Nia, P, Bramer, S, van Boven, W J P, Vonk, A B A, Koene, B M J A, Bekkers, J A, Hoohenkerk, G J F, Markou, A L P, de Weger, A, Segers, P, Porta, F, Speekenbrink, R G H, Stooker, W, Li, W W L, Daeter, E J, van der Kaaij, N P & Douglas, Y 2022, ' Minimally invasive approach compared to resternotomy for mitral valve surgery in patients with prior cardiac surgery : retrospective multicentre study based on the Netherlands Heart Registration ', European Journal of Cardio-thoracic Surgery, vol. 62, no. 5, ezac420 . https://doi.org/10.1093/ejcts/ezac420 |
| ISSN: | 1010-7940 |
| Popis: | OBJECTIVES Mitral valve (MV) surgery after prior cardiac surgery is conventionally performed through resternotomy and associated with increased morbidity and mortality. Alternatively, MV can be approached minimally invasively [minimally invasive mitral valve surgery (MIMVS)], but longer-term follow-up of this approach for MV surgery after prior cardiac surgery is lacking. Therefore, the aim of the current study is to evaluate short- and mid-term outcomes of MIMVS versus MV surgery through resternotomy in patients with prior sternotomy, using a nationwide registry. METHODS Patients undergoing isolated MV surgery after prior cardiac surgery between 2013 and 2018 were included. Primary outcomes were short-term morbidity and mortality and mid-term survival. Cox proportional hazard analysis was used to investigate the association between surgical approach and mortality. Propensity score matching was used to correct for potential confounders. RESULTS In total, 290 patients underwent MV surgery after prior cardiac surgery, of whom 205 patients were operated through resternotomy and 85 patients through MIMVS. No significant differences in 30-day mortality (3.4% vs 2%, P = 0.99) were observed between both groups. Five-year survival was 86.3% in the resternotomy group, compared to 89.4% in the MIMVS group (log-rank P = 0.45). In the multivariable analysis, surgical approach showed no relation with mid-term mortality [hazard ratio 0.73 (0.34–1.60); P = 0.44]. A lower incidence of prolonged intubation and new-onset arrhythmia was observed in MIMVS. CONCLUSIONS MV surgery after prior cardiac surgery has excellent short- and mid-term results in the Netherlands, and MIMVS and resternotomy appear to be equally efficacious. MIMVS is associated with a lower incidence of new-onset arrhythmia and prolonged intubation. |
| Databáze: | OpenAIRE |
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