Comparative analysis of minithoracotomy and sternotomy in the pathology of mitral valve - the experience of one center
Objective. To compare the immediate results of minithoracotomy with mitral valve disease. Material and methods. A retrospective analysis of the surgery of 305 patients with mitral valve disease, which were operated from 2009 to 2015. The average age of patients was 51 (43; 56). The studied population included 99 (41%) males, median ejection fraction - 60 (55; 65)%, volume of the left atrial - 116 (87; 148) ml, systolic pressure of the pulmonary artery - 40 (35; 50) mm Hg, atrial fibrillation in history - in 82 (34%), valve insufficiency - 117 (48.5%). The patients were divided into 2 groups: group 1 - 168 patients with minithoracotomy and group 2 - 73 patients with sternotomy. Results. In patients with a minithoracotomy, a longer cardiopulmonary time was 119.1 ± 32 min than in the control group 96.1 ± 32 min, p < 0.001 and the time of myocardial ischemia 75 (62; 93) min and 68 (54; 80) min, p = 0.005). The length of stay in the intensive care unit, the period of hospitalization in both groups was not significantly different. Postoperative blood loss was statistically significantly less in group 1 - 200 (150; 250) ml than group 2 - 275 (250; 450) ml, p < 0.001 and the number of pericarditis requiring puncture or drainage of the pericardium in group 1 - 2 (1.2%), in group 2 - 6 (8.2%), p = 0.01. There are no statistically significant differences in postoperative wound suppuration, neurological complications (stroke, delirium), tamponade, pleural punctures and drainage, as well as in total hospital mortality. Conclusion. The minithoracotomy in mitral valve (MV) surgery, in addition to the cosmetic results, has other advantages: reducing the postoperative blood loss, reducing the number of postoperative pericarditis.