Postoperative Outcomes of Minimally Invasive versus Conventional Mitral Valve Repair; A Randomized Study

Ehab Nourelden; Ahmed EL-Minshawy; Ahmed  Ghoneim; Mohammed Alaa; Yusuf Shieba

doi:10.35810/ects.v3i2.176

Ehab Nourelden Department of cardiac surgery, National Heart Institute, Giza, Egypt
Ahmed EL-Minshawy Department of Cardiothoracic Surgery, Faculty of Medicine, Assuit University, Assuit, Egypt
Ahmed Ghoneim Department of Cardiothoracic Surgery, Faculty of Medicine, Assuit University, Assuit, Egypt
Mohammed Alaa Department of Cardiothoracic Surgery, Faculty of Medicine, Assuit University, Assuit, Egypt
Yusuf Shieba Department of cardiothoracic surgery, Faculty of Medicine, South Valley University, Qena, Egypt https://orcid.org/0000-0002-0565-7795

DOI: https://doi.org/10.35810/ects.v3i2.176

Keywords: Minimal invasive mitral valve surgery, Mitral valve repair

Abstract

Background: Minimally invasive mitral valve surgery (MIMVS) is associated with less surgical trauma. However, its advantages over the conventional approach are controversial. This study aims to compare the early postoperative pain, hospital stay, and pulmonary function between minimally invasive and conventional mitral repair.

Methods: Fifty patients with non-ischemic mitral valve disease who had mitral valve repair between 2017 and 2019 were included in the study. Patients were randomly divided into two equal groups. Group A (n=25) included patients who had minimally invasive mitral valve repair via anterolateral mini-thoracotomy with video assistance, and Group B (n=25) included patients who had mitral valve repair via median sternotomy.

Results: The cross-clamp (99.45±16.01 vs. 87. 5±19.16 min; p= 0.058) and the total bypass times (134.08±27.38 vs. 120.71±22.18 min; p= 0.35) were nonsignificantly longer in Group A. Operative time was significantly longer in Group A (207.08±44.31 vs. 173.54±28.25 min; p= 0.001). The ICU stay in Group (A) was 2.58±1.44 days, and in Group (B), the ICU stay was 3.75±1.77 days (p= 0.001). The hospital stay was 7.87±1.59 days in Group A, and 14.5 ±5.05 days in Group B (P<0.001). Postoperative FEV1 was 2.06±0.63 L in Group A and 1.39±0.43 L in Group B (p= 0.001). There was no difference in postoperative ejection fraction between both groups (p= 0.9).

Conclusion: Minimal invasive mitral valve repair could reduce postoperative pain, length of ICU, and hospital stay and improve the postoperative respiratory function when compared to the conventional approach.