Port-Access (TM) mitral valve surgery: Summary of results

Background: The purpose of this study was to review the short-term results of an initial experience with minimally invasive cardiac valve surgery usin g the Port-Access(TM) approach in terms of Feasibility, safety, and reprodu cibility. Methods: Between October 1995 and October 1997, 151 minimally inv asive cardiac valve procedures were performed at our institution using the port-Access(TM) approach. The patients' mean age was 58.1 years (range 21 t o 91 years) and 50% were male. Aortic valve replacement was performed in 35 (23.2%) patients, mitral valve repair in 56 (37.1%) patients, mitral valve replacement in 36 (23.8%) patients, and complex valve procedures in 24 (15 .9%) patients. Results: The operative mortality rate for isolated mitral va lve surgery was 1.1% (1/92) and for all mitral valve surgery 3.5% (4/113). The operative mortality rate for isolated aortic valve patients was 5.7% (2 /35). For the total group the operating mortality was 4% (6/151). Early com plications for mitral valve patients included reoperation for breeding or t amponade in 5 (4.4%) patients, myocardial infarction in 2 (1.2%) patients, and transient ischemic attack and wound infection in 1 (0.1%) patient each. One patient required reoperation for mitral valve failure that resulted in aortic dissection unrelated to the Endoaortic Clamp(TM) catheter and ultim ately led to death. Two (5.6%) aortic valve patients required reoperation f or bleeding and two (5.6%) required reoperation for tamponade. Conclusions: Minimally invasive Port-Access(TM) techniques can be applied to most patie nts with valvular heart disease with minimal morbidity and mortality and go od postoperative valve function and may be the preferred approach for isola ted mitral and aortic valve surgery.