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Mitral valve operation via Port Access versus median sternotomy.

Publication ,  Journal Article
Glower, DD; Landolfo, KP; Clements, F; Debruijn, NP; Stafford-Smith, M; Smith, PK; Duhaylongsod, F
Published in: Eur J Cardiothorac Surg
October 1998

OBJECTIVE: The advantages and disadvantages of minimally invasive Port Access mitral valve operation have not been defined relative to standard median sternotomy. A study was therefore designed to delineate differences in outcome from mitral operation via Port Access versus sternotomy in comparable patients. METHODS: The records of 41 consecutive patients undergoing isolated mitral valve replacement (n = 14) or repair (n = 27) were examined. All operations were performed using cardioplegic arrest through either median sternotomy (n = 20) or a small right anterolateral thoracotomy using an endoaortic clamp and catheter system (Heartport, Redwood City, CA) to arrest and decompress the heart (Port Access, n = 21). RESULTS: Both groups were well matched for age, mitral pathology, ejection fraction, and comorbidity. except that Port Access patients were less likely to be female. Three patients had undergone previous cardiac operations. Surgical procedure time was longer for Port Access patients (384+/-80 vs. 263+/-41 min, P < 0.05). Port Access provided significantly smaller incision length (8+/-2 vs. 26+/-2 cm, P < 0.01) and similar or shorter hospital stay (6+/-4 vs. 7+/-3 days). Port Access provided excellent visualization of the mitral valve and subvalvular apparatus, generally better than sternotomy, to allow complex mitral valve repairs. The greatest advantage of Port Access mitral operation was that Port Access patients returned to normal activity more rapidly (4+/-2 vs. 9+/-1 weeks, P = 0.01) than did patients undergoing standard median sternotomy. CONCLUSIONS: By avoiding a sternotomy, Port Access mitral valve operation provided a smaller incision and a dramatically more rapid return to normal activity than did median sternotomy. Port Access cardioplegic arrest with the Heartport system allowed visualization of the mitral valve superior to median sternotomy and has become the standard approach at this institution.

Duke Scholars

Published In

Eur J Cardiothorac Surg

DOI

ISSN

1010-7940

Publication Date

October 1998

Volume

14 Suppl 1

Start / End Page

S143 / S147

Location

Germany

Related Subject Headings

  • Time Factors
  • Thoracotomy
  • Sternum
  • Respiratory System
  • Mitral Valve
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Prosthesis Implantation
 

Citation

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Glower, D. D., Landolfo, K. P., Clements, F., Debruijn, N. P., Stafford-Smith, M., Smith, P. K., & Duhaylongsod, F. (1998). Mitral valve operation via Port Access versus median sternotomy. Eur J Cardiothorac Surg, 14 Suppl 1, S143–S147. https://doi.org/10.1016/s1010-7940(98)00123-7
Glower, D. D., K. P. Landolfo, F. Clements, N. P. Debruijn, M. Stafford-Smith, P. K. Smith, and F. Duhaylongsod. “Mitral valve operation via Port Access versus median sternotomy.Eur J Cardiothorac Surg 14 Suppl 1 (October 1998): S143–47. https://doi.org/10.1016/s1010-7940(98)00123-7.
Glower DD, Landolfo KP, Clements F, Debruijn NP, Stafford-Smith M, Smith PK, et al. Mitral valve operation via Port Access versus median sternotomy. Eur J Cardiothorac Surg. 1998 Oct;14 Suppl 1:S143–7.
Glower, D. D., et al. “Mitral valve operation via Port Access versus median sternotomy.Eur J Cardiothorac Surg, vol. 14 Suppl 1, Oct. 1998, pp. S143–47. Pubmed, doi:10.1016/s1010-7940(98)00123-7.
Glower DD, Landolfo KP, Clements F, Debruijn NP, Stafford-Smith M, Smith PK, Duhaylongsod F. Mitral valve operation via Port Access versus median sternotomy. Eur J Cardiothorac Surg. 1998 Oct;14 Suppl 1:S143–S147.
Journal cover image

Published In

Eur J Cardiothorac Surg

DOI

ISSN

1010-7940

Publication Date

October 1998

Volume

14 Suppl 1

Start / End Page

S143 / S147

Location

Germany

Related Subject Headings

  • Time Factors
  • Thoracotomy
  • Sternum
  • Respiratory System
  • Mitral Valve
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Prosthesis Implantation