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You are here: Contents > 2016 > Volume 25 Number 4 July 2016 > MINIMALLY INVASIVE SURGERY > Outcomes of Minimally Invasive Valve Surgery in Patients with Multiple Previous Cardiac Operations

Outcomes of Minimally Invasive Valve Surgery in Patients with Multiple Previous Cardiac Operations

Orlando Santana1, Rama Krishna1, Nisharahmed Kherada1, Christos G. Mihos2,3

1Columbia University, Mount Sinai Heart Institute, Miami Beach FL, USA,
2Massachusetts General Hospital, Boston MA, USA
3Electronic correspondence: cmihos@mgh.harvard.edu

Background and aim of the study: The study aim was to evaluate the outcomes of minimally invasive valve surgery, performed via a right anterior thoracotomy approach, in patients with a history of multiple (more than two) prior cardiac surgeries.

Methods: A retrospective review was conducted of all minimally invasive valve operations performed in patients with a prior history of two or more cardiac surgeries, including coronary artery bypass grafting (CABG) and/or valve surgery, at the authors’ institution between January 2008 and November 2014.

Results: A total of 38 consecutive patients (23 males, 15 females; mean age 65.8 ± 14.6 years) were identified. Nine patients (24%) had two prior CABG operations, 18 (47%) had more than two prior valve surgeries, and 11 (29%) had a cardiac operative history that included both


CABG and valve surgery. A total of 34 (89.5%) isolated valve procedures was identified; these consisted of 24 (64%) mitral valve operations, nine (23.7%) aortic valve replacements, and one (0.3%) tricuspid valve repair. Four patients (10.5%) underwent combined mitral and tricuspid valve surgery. Postoperatively, two patients (5.3%) had cerebrovascular accidents, three (7.9%) required reoperation for bleeding, and three (7.9%) had acute kidney injury. The median hospital length of stay was 9.5 days (IQR: 7-16 days). The 30-day mortality was 7.9%. The cumulative survival at one year was 82%, and was 72% at five years.

Conclusion: Minimally invasive reoperative valve surgery after multiple prior cardiac operations is safe and feasible, with good perioperative outcomes and mid-term survival.

The Journal of Heart Valve Disease 2016;25:487-490


Outcomes of Minimally Invasive Valve Surgery in Patients with Multiple Previous Cardiac Operations

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