Minimally invasive triple valve surgery: A single center experience

J Card Surg. 2020 Oct;35(10):2567-2573. doi: 10.1111/jocs.14835. Epub 2020 Jul 15.

Abstract

Objective: Minimally invasive surgery is a widely accepted surgical treatment for valve disease, however triple valve surgery (TVS) is a complex and challenging procedure. The objective of this study was to describe the morbidity and mortality related to minimally invasive TVS at our institution.

Methods: This was a retrospective review of all minimally invasive TVS performed between 2012 and 2019. Baseline and perioperative characteristics were reviewed, as were postoperative outcomes.

Results: Eighteen patients underwent TVS; 12 patients underwent additional procedures at the time of TVS. Median time to initial extubation was 11.5 hours (interquartile range [IQR] 9.8-13.3). Intensive care unit and total length of stay were 1.22 (IQR, 1.16-1.31) and 9 (IQR, 6-17) days, respectively. No hospital deaths occurred; 30-, 90-, and 365-day mortality were 0%. Two postoperative neurologic complications occurred, two patients had acute kidney injuries. The most common complication was rhythm disturbance with five patients requiring permanent pacemaker implantation. Mean follow-up was 39.9 months (252-2642 days).

Conclusions: Our findings demonstrate that minimally invasive TVS utilizing femoral cannulation results in an acceptable risk of complication. Short and intermediate term survival were excellent.

Keywords: minimally invasive; minithoracotomy; triple valve surgery.

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology
  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery*
  • Cardiac Valve Annuloplasty / methods*
  • Female
  • Follow-Up Studies
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Mitral Valve / surgery*
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Tricuspid Valve / surgery*