MP10. Comparison of long-term results of mitral valvuloplasty with minimally invasive and median sternotomy approach for rheumatic mitral valve disease
Presented During: Moderated E-Posters
Southern Medical University
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Name: Huan-lei Huang
Title: Cardiac Surgeon; Professor in Cardiovascular Surgery; Head, Department of Cardiac Valve Surgery and Minimally Invasive Cardiac Surgery
Dr. Huang studied medicine in Gannan Medical College in Jiangxi Province, China. In 1998, he completed his surgical residence program at the First Affiliated Hospital of Gannan Medical College. In 2002, he completed his cardiac surgery training at Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital, Guangdong Provincial Cardiovascular Institute in Guangzhou. He was working in University of Rochester Medical Center in USA as visiting scholar from Nov 2004 to Nov 2005. He is the member of International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS), and the member of the Society of Cardiothoracic Surgery, Chinese Medical Association.
Research Interests: Dr. Huang’s expertise is in minimally invasive cardiac surgery and surgical treatment of end-stage heart failure. He performed the first minimally invasive valve surgery from ministernotomy in 2007 (aortic), the first totally endoscopic mitral valve repair in 2012, and the first totally endoscopic mitral valve re-replacement on beating-heart in 2015. In the past several years, he performed totally endoscopic cardiac surgery up to 300 cases per year, including at least 100 cases of totally endoscopic mitral valve repair. He developed a new operation for patients with severe tricuspid regurgitation following cardiac surgery, with decreasing mortality of surgery. His paper entitled “A novel beating-heart totally endoscopic tricuspid valvuloplasty technique with patch augmentation in reoperative cardiac surgery” was accepted for presentation at the AATS 98th annual meeting, April 28 – May 1, 2018, San Diego, CA, and paper entitled “Outcomes of beating-heart totally endoscopic tricuspid valvuloplasty in reoperative cardiac surgery” was accepted for presentation at the 2019 Annual Scientific Meeting of International Societ
Thursday, May 4, 2023: 6:30 PM - Saturday, May 6, 2023: 2:29 AM
New York Hilton Midtown
Room: Grand Ballroom Foyer
Description
Objective: It is unknown whether video aided thoracoscopic mitral valve repair(VATS-MVP) in patients with Rheumatic heart disease(RHD) differs from conventional median sternotomy(MS) approach in terms of preoperative patient selection, intraoperative surgical strategy, perioperative results, and long-term prognosis. The aim of this study was to examine the safety, efficacy and durability of VATS-MVP in RHD.
Methods: A retrospective collection with clinical data, echocardiography results, and follow-up data was used to identify 235 consecutive patients underwent MVP for RHD from January 2007 through June 2022, including 114 patients via MS approach and 121 patients via VATS approach(Table 1). A comparison between the MS group and the VATS group was conducted.
Results: One patient death in hospital was observed in the VATS group. Follow-up was 96.1% complete (range, 0.15-14.8 years). There was a higher percentage of artificial ring implantation in the VATS group, but there was no difference between the two groups(P=0.246). Although the total operation time (227.9±72.8 vs 235.2±63.3 min, P=0.155) between the two groups was not statistical different, the VATS group had longer cardiopulmonary bypass time(159.9±46.3 vs 134.9±48.3min, P=0.000) and aortic clamp time(102.9±32.6 vs. 87.5±34.5 min, P=0.001) . The incidence of lung infection and poor wound healing was high in MS group(P<0.05). Pleural effusion is common in VATS group(P<0.05). No significant difference between the two groups in other adverse perioperative complications(P>0.05). Mechanical ventilation time (P=0.015), ICU time(P=0.153), and postoperative hospitalization time(P=0.230) were all shorter in the VATS group. Two patients in the MS group died during the follow-up period. The 1-year, 5-year and 10-year survival rates of VATS groups were all 99.2%. At 1-year, 5-year, 10-year in the AVTS group, the rate of freedom from moderate or greater(>=2+) mitral regurgitation were 87.6%, 74.3%,and 74.3%, respectively. Compared with MS group, there was no significant difference in the survival rate, recurrence rate of mitral regurgitation, reoperation rate and incidence rate of adverse cardiovascular and cerebrovascular events in VATS group(P＞0.05).
Conclusions: Rheumatic mitral valve disease could be effectively and safely repaired with excellent long-term durability via totally endoscopic minimally invasive approach in selected patients.
Methods: A retrospective collection with clinical data, echocardiography results, and follow-up data was used to identify 235 consecutive patients underwent MVP for RHD from January 2007 through June 2022, including 114 patients via MS approach and 121 patients via VATS approach(Table 1). A comparison between the MS group and the VATS group was conducted.
Results: One patient death in hospital was observed in the VATS group. Follow-up was 96.1% complete (range, 0.15-14.8 years). There was a higher percentage of artificial ring implantation in the VATS group, but there was no difference between the two groups(P=0.246). Although the total operation time (227.9±72.8 vs 235.2±63.3 min, P=0.155) between the two groups was not statistical different, the VATS group had longer cardiopulmonary bypass time(159.9±46.3 vs 134.9±48.3min, P=0.000) and aortic clamp time(102.9±32.6 vs. 87.5±34.5 min, P=0.001) . The incidence of lung infection and poor wound healing was high in MS group(P<0.05). Pleural effusion is common in VATS group(P<0.05). No significant difference between the two groups in other adverse perioperative complications(P>0.05). Mechanical ventilation time (P=0.015), ICU time(P=0.153), and postoperative hospitalization time(P=0.230) were all shorter in the VATS group. Two patients in the MS group died during the follow-up period. The 1-year, 5-year and 10-year survival rates of VATS groups were all 99.2%. At 1-year, 5-year, 10-year in the AVTS group, the rate of freedom from moderate or greater(>=2+) mitral regurgitation were 87.6%, 74.3%,and 74.3%, respectively. Compared with MS group, there was no significant difference in the survival rate, recurrence rate of mitral regurgitation, reoperation rate and incidence rate of adverse cardiovascular and cerebrovascular events in VATS group(P＞0.05).
Conclusions: Rheumatic mitral valve disease could be effectively and safely repaired with excellent long-term durability via totally endoscopic minimally invasive approach in selected patients.