Impact of minimally invasive valvular heart surgery: A case-control study

Background. The port access (PA) approach for valvular heart surgery is wid ely used, but few studies evaluating outcomes compared with the sternotomy approach have been performed. Methods. One hundred nine consecutive patients undergoing PA-isolated valve surgery were compared with 88 matched patients who underwent sternotomy-is olated valve surgery before the institution of the PA program. Case matchin g was performed by age, surgeon, congestive heart failure, position of oper ated valve, and history of previous surgery. Results. Analysis revealed that PA was associated with similar hospital mor tality (p = 0.62), longer bypass times (p < 0.001), shorter length of stay (p = 0.02), fewer transfusions (p = 0.02), and fewer septic complications ( p = 0.05). Conclusions. The PA approach for isolated valvular heart surgery provided p atients with significantly improved clinical outcomes in their immediate pe rioperative course. Further studies are required to measure the impact of t he PA approach on the patients' recovery after hospitalization. (C) 2001 by The Society of Thoracic Surgeons.