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Clinical results of minimally invasive open-heart surgery in patients with mitral valve disease: Comparison of parasternal and low-sternal approach

 Sak Lee  ;  Byung-chul Chang  ;  Sang-hyun Lim  ;  You-sun Hong  ;  Kyung-jong Yoo  ;  Meyun-shick Kang 
 YONSEI MEDICAL JOURNAL, Vol.47(2) : 230-236, 2006 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures/methods* ; Cardiopulmonary Bypass ; Female ; Heart Valve Prosthesis Implantation/methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods* ; Mitral Valve/pathology* ; Mitral Valve/surgery ; Mitral Valve Insufficiency/diagnosis* ; Mitral Valve Insufficiency/therapy* ; Models, Statistical ; Retrospective Studies ; Sternum/surgery ; Time Factors
Minimally invasive surgery ; mitral valve disease ; thoracotomy
Clinical results of minimally invasive mitral valve surgery were retrospectively reviewed, and two different surgical approaches were compared in this study. Between 1997 and 2004, a total of 86 patients with mitral valve disease underwent minimally invasive surgery at theYonsei University Cardiovascular Center. Age of patients averaged 41.6 ± 14.0 years and 69 patients were female. Surgical approach included lowsternal incisions with mini-sternotomy, and right parasternal or thoracotomy approach. Either direct aortic or femoral arterial and bicaval cannulations were used in all patients. Patients were divided into two groups according to the method of surgical approach (parasternal (P) vs low-sternal (L)), and the results were compared. Postoperative NYHA functional class improved to 1.1 ± 0.4 in all patients (no significant statistical difference between two groups). Mean wound length (P: 9.21 ± 1.10 vs L: 11.24 ± 0.82 cm, p<0.05), and mechanical ventilation time (P: 10.42 ± 4.36 vs L: 12.90 ± 5.00 min, p=0.04) was significantly shorter in parasternal group, and mean operation time(P:294.74 ± 59.41 vs. L:259.31 ± 54.36 min, p=0.03) was significantly shorter in low-sternal group. Mean cardiopulmonary bypass time, and aortic cross clamp time was also shorter in low-sternal group without statistical difference. There were 2 minor wound complications in all patients (p=NS), and no hospital death. Comparing the two different surgical approach of minimally invasive mitral valve surgery, parasternal approach is thought to be more beneficial in reducing postoperative scar, and intubation time.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Meyun Shick(강면식)
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Yu, Song Hyeon(유송현)
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Lim, Sang Hyun(임상현)
Chang, Byung Chul(장병철)
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