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Eur J Cardiothorac Surg 1998;14:141-147
© 1998 Elsevier Science NL

Clinical experiences with minimally invasive mitral valve surgery using a simplified port access^TM technique¹

Cardiovascular Institute, University Hospital Dresden, Fetscherstrasse 76, D-01307 Dresden, Germany

Received 29 December 1997; received in revised form 20 April 1998; accepted 28 April 1998.

Corresponding author. Tel.: +49 351 4501801; fax: +49 351 4501802.

Objective: Using the initial experiences with the Port-Access^TM technique for the treatment of mitral valve disease some changes were made thus resulting in more simple and faster procedures. Methods: Twenty-nine patients (13 male, 16 female, aged 30 to 75 years, median 62.5±11.0 years) underwent minimally invasive mitral valve surgery between May 1996 and December 1997. The underlying diseases were: mitral valve insufficiency (n=16), mitral valve stenosis (n=7) and combined mitral valve disease (n=6). Through a small right thoracotomy (5–7 cm) access to the pericardium and the heart was gained. Cardiopulmonary bypass was instituted through femoral cannulation and an intraaortic balloon-catheter was introduced for aortic occlusion, aortic root venting and delivery of cold crystalloid cardioplegia. Mitral valve repair (five patients) or replacement (24 patients) was performed. Results: There was no death during the whole follow-up period. There was no perivalvular leak and only minor residual mitral valve regurgitation was observed on intraoperative or postoperative (3 months) transesophageal echocardiography in three patients. There was no postoperative study-related complication. Time of ventilation and intensive care unit were comparable with the data of patients undergoing conventional mitral valve surgery but hospital stay was shorter in the last 10 consecutive cases. Conclusions: This simplified technique of mitral valve surgery combines the advantage of less invasive operative and good cosmetic results with the safety of conventional mitral valve surgery. At our institution this technique presents in well selected patients suffering from mitral valve disease the procedure of choice.

Key Words: Minimally invasive cardiac surgery • Endovascular cardiopulmonary bypass system • Mitral valve disease

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