VALVE OPERATIONS THROUGH A MINIMALLY INVASIVE APPROACH

Background. We analyzed in-hospital results of 87 patients undergoing minimally invasive valvular operations (right parasternal incision thr ough third and fourth cartilages). Methods. Age was 21 to 84 years (me an, 56.2 +/- 16); 45 patients (51.7%) were female. Five (5.7%) had a p revious valvular operation and 8 (9.2%) had severe left ventricular dy sfunction. Valve diseases were as follows: aortic in 35 patients (40.2 %), mitral in 44 (50.5%), double in 5 (5.7%), tricuspid regurgitation in 2 (2.2%), and mitral periprosthetic leak in 1 (1.1%). Results. Nine teen mitral repairs (21.9%), 22 replacements (25.3%), 1 leak closure ( 1.1%), 1 tricuspid repair (1.1%), and 1 replacement (1.1%) were perfor med. Thirty-one patients (35.7%) underwent aortic replacement 2 (2.3%) aortic decalcification, 1 (1.1%) subaortic membrane resection, 4 (4.6 %) a double-valve procedure, and 5 (5.7%) a single-valve operation com bined with myocardial revascularization. In-hospital mortality was 5.7 % (5 patients). Univariate analysis was significant for previous opera tion, New York Heart Association class IV and severe ventricular dysfu nction. Multivariate analysis was significant for previous operation a nd severe ventricular dysfunction. Atrial fibrillation (12.6%) was the most frequent complication. Postoperative stay was 6.5 +/- 6 days.Con clusions. The minimally invasive approach is a useful. technique in va lvular surgery. Patients with a previous valvular operation, severe ve ntricular dysfunction, and New York Heart Association class IV dyspnea have higher in-hospital mortality.