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Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study.

Publication ,  Journal Article
Tang, P; Onaitis, M; Gaca, JG; Milano, CA; Stafford-Smith, M; Glower, D
Published in: Ann Thorac Surg
August 2015

BACKGROUND: The efficacy of conventional median sternotomy versus a right minithoracotomy (RT) approach to mitral valve surgery was evaluated in a single high-volume institution. METHODS: A retrospective analysis of a single institution's experience was performed using propensity matching of 1,694 patients who underwent mitral valve surgery during a 15-year period. Patients who had procedures that were not usually performed through an RT approach were excluded. Using 1:1 propensity score matching, we obtained 215 matched patients in each group for outcomes analysis. RESULTS: There was no difference in the median year of operation between the two groups (2002 versus 2001; p = 0.142). The RT approach was not a predictor of postoperative mortality. Predictors of mortality included increasing age, diabetes, smoking, preoperative dialysis, lung disease, advanced congestive heart failure class, and peripheral vascular disease. The RT approach was associated with less new-onset atrial fibrillation (8% versus 16%; p = 0.018), pneumonia (1% versus 5%; p = 0.049), respiratory failure (3% versus 8%; p = 0.036), and acute renal failure (2% versus 7%; p = 0.006), lower chest tube output (350 versus 840 mL; p < 0.001), and fewer red blood transfusions (2 versus 3 units; p = 0.001). CONCLUSIONS: Right minithoracotomy compared with median sternotomy for mitral valve surgery was associated with less postoperative atrial fibrillation, respiratory complications, acute renal failure, chest tube output, and use of packed red blood cells. Given study limitations, the RT approach for mitral valve surgery may have advantages over median sternotomy in selected patients.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2015

Volume

100

Issue

2

Start / End Page

575 / 581

Location

Netherlands

Related Subject Headings

  • Thoracotomy
  • Sternotomy
  • Retrospective Studies
  • Respiratory System
  • Propensity Score
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Diseases
 

Citation

APA
Chicago
ICMJE
MLA
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Tang, P., Onaitis, M., Gaca, J. G., Milano, C. A., Stafford-Smith, M., & Glower, D. (2015). Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study. Ann Thorac Surg, 100(2), 575–581. https://doi.org/10.1016/j.athoracsur.2015.04.027
Tang, Paul, Mark Onaitis, Jeffrey G. Gaca, Carmelo A. Milano, Mark Stafford-Smith, and Donald Glower. “Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study.Ann Thorac Surg 100, no. 2 (August 2015): 575–81. https://doi.org/10.1016/j.athoracsur.2015.04.027.
Tang P, Onaitis M, Gaca JG, Milano CA, Stafford-Smith M, Glower D. Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study. Ann Thorac Surg. 2015 Aug;100(2):575–81.
Tang, Paul, et al. “Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study.Ann Thorac Surg, vol. 100, no. 2, Aug. 2015, pp. 575–81. Pubmed, doi:10.1016/j.athoracsur.2015.04.027.
Tang P, Onaitis M, Gaca JG, Milano CA, Stafford-Smith M, Glower D. Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study. Ann Thorac Surg. 2015 Aug;100(2):575–581.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2015

Volume

100

Issue

2

Start / End Page

575 / 581

Location

Netherlands

Related Subject Headings

  • Thoracotomy
  • Sternotomy
  • Retrospective Studies
  • Respiratory System
  • Propensity Score
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Diseases