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ORIGINAL ARTICLE
Year : 2022  |  Volume : 5  |  Issue : 4  |  Page : 487-491

Comparative study between right-sided minithoracotomy versus upper partial ministernotomy in isolated mitral valve replacement (early outcome)


1 Department of Cardiothoracic Surgery, National Heart Institution, Cairo, Egypt
2 Department of Cardiology, National Heart Institution, Cairo, Egypt

Correspondence Address:
Hazem G Bakr
Department of Cardio-Thoracic Surgery, Lecturer of Cardiac Surgery, National Heart Institute, KitKat Square, Imbaba, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmisr.jmisr_13_22

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Background In recent years, minimally invasive surgical techniques have become increasingly popular in heart surgery. The most common incisions used in minimally invasive mitral valve replacement are ministernotomy and minithoracotomy. It is still up for dispute whether one incision is superior to the other. Patients and methods The results of 60 patients who had solitary mitral valve replacement were studied using a prospective comparative analysis. In group A (n = 30), a minimally invasive right anterior minithoracotomy technique was performed, whereas in group B (n = 30), a partial upper ministernotomy procedure was used. Results The results in both groups reveal no statistically significant difference. However, the hospital stay, ventilation time, and blood loss had better results in right minithoracotomy group, whereas in the upper ministernotomy group, postoperative pain had better results. In group A, blood loss was 325.3 ± 164.2, whereas in group B, it was 413.3 ± 159.3. In group B, postoperative pain was 1.9 ± 0.8 days better than group A (2.3 ± 0.7 days). Group A had a significantly longer operative time (295 ± 22.7) than group B (213 ± 28.4). In both groups, inotropes were determined to be negligible. Conclusion The results of a right anterior minithoracotomy and an upper ministernotomy approach in patients undergoing isolated mitral valve repair (MVR) are similar, with no notable differences. However, a right anterior minithoracotomy reduces (not significantly) the need for blood transfusions, assisted ventilation time, and hospital stay, whereas an upper ministernotomy reduces postoperative pain. Furthermore, the cross-clamping and the total operative time is highly significantly increased in the right anterior minithoracotomy approach.


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