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2023-06

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cc-by-nc-nd (c) Elsevier B.V., 2023
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/206333

Repair of Mitral Prolapse: Comparison of Thoracoscopic Minimally-invasive and Conventional Approaches

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Objectives: Surgical repair remains the best treatment for severe primary mitral regurgitation (MR). Minimally invasive mitral valve surgery is being increasingly performed, but there is a lack of solid evidence comparing thoracoscopic with conventional surgery. Our objective was to compare outcomes of both approaches for repair of leaflet prolapse. Methods: All consecutive patients undergoing surgery for severe MR due to mitral prolapse from 2012 to 2020 were evaluated according to the approach used. Freedom from mortality, reoperation and recurrent severe MR were evaluated by Kaplan-Meier method. Differences in baseline characteristics were adjusted with propensity score-matched analysis (1:1, nearest neighbour). Results: Three hundred patients met inclusion criteria and were divided into thoracoscopic (N = 188) and conventional (sternotomy; N = 112) groups. Unmatched patients in the thoracoscopic group were younger and had lower body mass index, New York Heart Association class and EuroSCORE II preoperatively. After matching, thoracoscopic group presented significantly shorter mechanical ventilation (9 vs 15 h), shorter intensive care unit stay (41 vs 65 h) and higher postoperative haemoglobin levels (11 vs 10.2 mg/dl) despite longer bypass and cross-clamp times (+30 and +17 min). There were no differences in mortality or MR grade at discharge between groups nor differences in survival, repair failures and reinterventions during follow-up. Conclusions: Minimally invasive mitral repair can be performed in the majority of patients with mitral prolapse, without compromising outcomes, repair rate or durability, while providing shorter mechanical ventilation and intensive care unit stay and less blood loss.

Matèries

Ventricles cardíacs, Operacions quirúrgiques, Vàlvules cardíaques

Matèries (anglès)

Ventricle of heart, Surgical operations, Heart valves

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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ASCASO, María, SANDOVAL, Elena, MURO, Anna, BARRIUSO, Clemente, QUINTANA, Eduard, ALCOCER, Jorge, SITGES CARREÑO, Marta, VIDAL, Bàrbara, POMAR MOYA-PRATS, Josep lluís, CASTELLÀ PERICÀS, Manuel, GARCÍA-ÁLVAREZ, Ana, PEREDA, Daniel. Repair of Mitral Prolapse: Comparison of Thoracoscopic Minimally-invasive and Conventional Approaches. _European Journal of Cardio-Thoracic Surgery_. 2023. Vol. 64, núm. 2, pàgs. ezad235. [consulta: 10 de gener de 2026]. ISSN: 1010-7940. [Disponible a: https://hdl.handle.net/2445/206333]

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