Minimally invasive mitral valve surgery

The development of new cardiopulmonary bypass technologies, special surgica l instruments, as well as intrathoracic video systems facilitates mitral su rgery via a small right thoracotomy. Since September 1996, 35 patients (17 male and 18 female) have undergone mi nimally invasive mitral valve surgery at our department. Mean age was 58 +/ - 11 years. In 18 patients the Port-Access(TM) system with an endoaortic ba lloon clamp was used, 17 patients had video-assisted surgery with a transth oracic aortic crossclamp. Fourteen mitral valves were replaced, 21 were rep aired. In 21 cases a complex mitral valve procedure was performed. Mean len gth of incision was 7 cm. Mean operating time lasted 265 +/- 43 min, mean b ypass time 154 +/- 33 min, mean crossclamp time 94 +/- 27 min. Despite initially longer operation and cardiopulmonary bypass time, clinica l outcome and postoperative valve function were good. The crossclamp techni que is simpler to perform and avoids the specific risk factors associated w ith the Port Access(TM) method. The cosmetic results are excellent and the risk of wound infection is reduced. Up to now improved recovery during hosp ital stay has not been realized.