gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Extended indications of operative spectrum via right lateral mini-thoracotomy

Meeting Abstract

  • Udo Boeken - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf
  • Jan-Philipp Minol - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf
  • Arash Mehdiani - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf
  • Hiroyuki Kamiya - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf
  • Hildegard Gramsch-Zabel - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf
  • Payam Akhyari - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf
  • Artur Lichtenberg - Uniklinik Düsseldorf, Kardiovaskuläre Chirurgie, Düsseldorf

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch173

DOI: 10.3205/12dgch173, URN: urn:nbn:de:0183-12dgch1739

Published: April 23, 2012

© 2012 Boeken et al.
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Outline

Text

Introduction: A right lateral mini-thoracotomy with femoral cannulation for cardiopulmonary bypass is an increasingly used approach for mitral valve surgery (MVS). Outcomes after procedures other than MVS have not been well described.

Materials and methods: We retrospectively reviewed 168 cardiac operations via right lateral mini-thoracotomy (MIC) with femoral cannulation between 8/2009 and 7/2011. We investigated the short-term morbidity and mortality with regard to the surgical procedure and 1-year-follow-up data including echocardiography.

Results: Of the 168 MIC-Patients, 120 had isolated mitral valve operations (102 repairs, 18 replacements). Furthermore, there were 30 combined procedures with additional surgery of the tricuspid valve (TV) ( including 7 procedures with removal of infected pacemaker- or ICD-leads), 5 patients with an isolated TV-procedure, 6 patients with resection of atrial tumors, 7 cases of closure of atrial septal defects.

Overall in-hospital mortality was 4.8% (8 of 168). In the indivdual groups, it was each 3.3 % in the groups of patients with isolated MV-surgery and with combined procedures, and 20 % (1 of 5) in the isolated TV-group. In patients with resection of tumors or ASD-closures no in-hospital mortality could be observed.

Length of ICU - and hospital-stay were 1.8 ± 2.1 days and 11.7 ± 4.8 d in all 168 patients (Isolated MVS: 1.3 ± 0.8 d, 11.3 ± 3.3 d; other groups: 2.9 ± 2.8 days, 11.9 ± 5.2 d, respectively).

At follow-up, survival was 94.6 % in total. Freedom from reoperation was 92.8 %. Mean left ventricular ejection fraction decreased from 61.8 ± 10 % at hospital discharge to 58.9 ± 9.7 % (p > 0.05) at follow in all patients.

Conclusion: Right lateral mini-thoracotomy is a routinely used access for MV-surgery. With our data we could confirm this technique for a wide spectrum of operative procedures that can also be performed with excellent results.