Minimally Invasive Video-assisted Double-valve Replacement through Right Anterolateral Minithoracotomy

Objective This study aimed to investigate feasibility and safety of minimally invasive video-assisted surgery for double-valve (mitral and aortic) replacement through right anterolateral minithoracotomy. Methods Between February 2011 and April 2013, 60 patients with combined valvular disease underwent double valve replacement, 26 of them by minimally invasive video-assisted surgery through right anterolateral minithoracotomy (study group) and 34 by median sternotomy (control group). Peripheral cardiopulmonary bypass (CPB) was established through right femoral artery and vein. The incision was made around the right breast approximately 5cm in length. Pericardiotomy, bicaval occlusion, atriotomy and aortotomy, and double valve replacement were performed with thoracoscope. Results In the study group, times of CPB and aortic cross-clamp were 146.5±40.5min and 91.5±23.4 min, respectively, which were significantly different from those in the control group, 115.4±26.5min and 75.4±16.5min ( P P P P >0.05). All patients recovered smoothly with follow-up of six months to two years, with no severe complications. Conclusions Minimally invasive video-assisted procedure through right anterolateral minithoracotomy is a new promising approach for double valve replacement. Our study suggested that this approach was feasible, safe and had cosmetic effects.