HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Selami Dogan Tayfun Aybek Petar S. Risteski Gerhard Wimmer-Greinecker Anton Moritz Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dogan, S. Articles by Moritz, A. Search for Related Content PubMed PubMed Citation Articles by Dogan, S. Articles by Moritz, A.

Ann Thorac Surg 2005;79:492-498
© 2005 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Minimally Invasive Port Access Versus Conventional Mitral Valve Surgery: Prospective Randomized Study

Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany

Accepted for publication August 5, 2004.

^* Address reprint requests to Dr Dogan, Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590 Frankfurt am Main, Germany (E-mail: s.dogan{at}em.uni-frankfurt.de).

BACKGROUND: We compared the port access mitral valve surgery with the conventional procedure through median sternotomy in a prospective randomized study.

METHODS: Forty elective patients with mitral valve disease were prospectively randomized to undergo minimally invasive (group I) or conventional (group II) mitral valve operation. The patients of group I had limited access through right small anterior thoracotomy and a femorofemoral cardiopulmonary bypass system using the endoclamp technique. To assess the efficiency and safety of the procedure, intraoperative and postoperative clinical data and markers of myocardial, cerebral, and lower limb ischemia were collected. Pulmonary function tests were performed to compare the preservation of pulmonary function. Neuropsychological tests were conducted for quantification of neurological and cognitive disorders.

RESULTS: Mitral valve reconstructions were performed in 28 patients (70%) in both groups. Intraoperative procedure-associated problems were experienced in 9 patients (45%) in group I, and 6 of them (30%) had to be converted to direct transthoracic aortic clamping. Markers of myocardial and cerebral damage as well as pulmonary and neuropsychological tests did not show statistically significant difference between groups.

CONCLUSIONS: The minimally invasive port access technique for mitral valve surgery can be done with similar clinical safety as procedures through median sternotomy. The problems with endoclamping have forced us to change our practice to the more simple and economic transthoracic aortic clamping technique.

This article has been cited by other articles:

				R. Umakanthan, M. Leacche, M. R. Petracek, S. Kumar, N. V. Solenkova, C. A. Kaiser, J. P. Greelish, J. M. Balaguer, R. M. Ahmad, S. K. Ball, et al. Safety of minimally invasive mitral valve surgery without aortic cross-clamp. Ann. Thorac. Surg., May 1, 2008; 85(5): 1544 - 1549. [Abstract] [Full Text] [PDF]

				E. Sagbas, B. Caynak, C. Duran, O. Sen, B. Kabakci, I. Sanisoglu, and B. Akpinar Mid-term results of peripheric cannulation after port-access surgery Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 744 - 747. [Abstract] [Full Text] [PDF]

				B. Kiaii, D. Bainbridge, and P. Fernandes Surgical, Anesthetic, Perfusion-Related Advances in Minimal Access Surgery Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2007; 11(4): 282 - 287. [Abstract] [PDF]

				K. Ak, T. Aybek, G. Wimmer-Greinecker, F. Ozaslan, F. Bakhtiary, A. Moritz, and S. Dogan Evolution of surgical techniques for atrial septal defect repair in adults: A 10-year single-institution experience J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 757 - 764. [Abstract] [Full Text] [PDF]

				T. Aybek, S. Dogan, P. S. Risteski, A. Zierer, T. Wittlinger, G. Wimmer-Greinecker, and A. Moritz Two hundred forty minimally invasive mitral operations through right minithoracotomy. Ann. Thorac. Surg., May 1, 2006; 81(5): 1618 - 1624. [Abstract] [Full Text] [PDF]

				D. Maselli, R. Pizio, G. Borelli, and F. Musumeci Endovascular balloon versus transthoracic aortic clamping for minimally invasive mitral valve surgery: impact on cerebral microemboli Interactive CardioVascular and Thoracic Surgery, April 1, 2006; 5(2): 183 - 186. [Abstract] [Full Text] [PDF]