Video-assisted thoracoscopic mitral valve replacement

To summarize the experience of mitral valve replacement (MVR) using video-assisted thoracoscope.Methods 28 cases of MVR were performed through three right anterior ports under thoracoscopy using femorofemoral extracorporeal circulation.The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold cardioplegic.33 patients underwent routine open approach MVR as control group.Results There was no death and no morbidity directly related to this approach.Comparing with control control gorup,time of extracorporeal circulation was 82～146 (96±38) min vs. 80～132(92±31) min,cross-clamped 37～76(47±18) min vs. 34～72(45±13) min and ventilation time were 8.6～14.8(10.2±3.1)h vs. 8.3～15.9(11.3±3.4)h.The volume of drainage was 50～230(72±28)ml in VATS group while 7～460(108±4.2)ml in control group (P<0.01),and hospital day were 8～12(10.1±2.2)d vs. 10～28(15.6±4.2)d (P<0.05).The pain in the VATS group was less postoperatively.Conclusion Video-assisted thoracoscopic MVR is a safe and effective technique with less drainage,shortened hospital stay and minor postoperative pain.4 refs,1 tab.