Antero-lateral Mini-thoracotomy Approach for Both Mitral and Aortic Valve Surgery with Direct Vision: “Miami Method"
Presented During:
Thursday, May 4, 2023: 6:30PM - Saturday, May 6, 2023: 2:29AM
New York Hilton Midtown
Posted Room Name:
Grand Ballroom Foyer
Abstract No:
MP004
Submission Type:
Abstract Submission
Authors:
Ergun Demirsoy (1), Harun Gulmez (2), Emre Doğan (1)
Institutions:
(1) N/A, N/A, (2) Sisli Kolan International Hospital, Istanbul, Turkey
Submitting Author:
Ergun Demirsoy
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Co-Author(s):
Harun Gulmez
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Sisli Kolan International Hospital
Sisli Kolan International Hospital
Emre Doğan
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Presenting Author:
Ergun Demirsoy
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Abstract:
Objective:
In recent years, various minimally invasive approaches have gained increasing recognition as an alternative to traditional median sternotomy in valve surgery and it can be regarded as an option to catheter-based interventions. Here, we aim to describe our experience with a modified technique called the "Miami Method," which involves a right mid-axillary anterolateral mini-thoracotomy.
Methods:
We conducted a clinical study on 25 patients, 15 of whom were male, with an average age of 59.2±15.4 (range 25-87). The study took place from October 2021 to December 2022, and all surgeries were performed using a 3rd or 4th right mid-axillary curved vertical incision with direct visualization.
Results:
Of the 25 patients, 5 received aortic valve replacement, 12 received mitral valve replacement or repair with additional tricuspid valve repair if needed, 1 received combined aortic and mitral valve replacement, 3 underwent tricuspid surgery only, 2 underwent combined mitral valve repair and CABG, 2 were operated on for sinus venosum defect and partial anomalous pulmonary venous return, and 3 received additional ablation procedures for AF. Of the 5 patients who had previously undergone surgery, 3 were operated with CPB support without cross-clamping.
The average cross-clamp time was 114±35 (range 67-207) minutes, and the total bypass time was 175±47 (range 119-299) minutes. There were no deaths, but one patient required revision surgery due to bleeding and one patient experienced a transient stroke that resolved without long-term effects.
Conclusions:
We believe that this surgical method, which allows for direct visualization, can be safely and successfully performed on high-risk patients and is suitable for performing complex mitral repair as well as aortic valve replacement.
In recent years, various minimally invasive approaches have gained increasing recognition as an alternative to traditional median sternotomy in valve surgery and it can be regarded as an option to catheter-based interventions. Here, we aim to describe our experience with a modified technique called the "Miami Method," which involves a right mid-axillary anterolateral mini-thoracotomy.
Methods:
We conducted a clinical study on 25 patients, 15 of whom were male, with an average age of 59.2±15.4 (range 25-87). The study took place from October 2021 to December 2022, and all surgeries were performed using a 3rd or 4th right mid-axillary curved vertical incision with direct visualization.
Results:
Of the 25 patients, 5 received aortic valve replacement, 12 received mitral valve replacement or repair with additional tricuspid valve repair if needed, 1 received combined aortic and mitral valve replacement, 3 underwent tricuspid surgery only, 2 underwent combined mitral valve repair and CABG, 2 were operated on for sinus venosum defect and partial anomalous pulmonary venous return, and 3 received additional ablation procedures for AF. Of the 5 patients who had previously undergone surgery, 3 were operated with CPB support without cross-clamping.
The average cross-clamp time was 114±35 (range 67-207) minutes, and the total bypass time was 175±47 (range 119-299) minutes. There were no deaths, but one patient required revision surgery due to bleeding and one patient experienced a transient stroke that resolved without long-term effects.
Conclusions:
We believe that this surgical method, which allows for direct visualization, can be safely and successfully performed on high-risk patients and is suitable for performing complex mitral repair as well as aortic valve replacement.
Mitral Conclave:
Minimally Invasive & Robotic Mitral Valve Repair
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