Right Ventricular Function After Minimally Invasive Mitral Valve Surgery.

Abstract

OBJECTIVES\nRight ventricular (RV) dysfunction is a significant cause of morbidity and mortality after cardiac surgery. Minimally invasive mitral valve surgery (MIMVS) increasingly is being performed. The authors aim was to evaluate postoperative RV function in patients who underwent MIMVS versus traditional mitral valve surgery.\n\n\nDESIGN\nSix hundred seventy-five patients who underwent elective isolated mitral valve surgery at Centro Cardiologico Monzino from January 2016 to December 2019 were analyzed. After 1:1 propensity score matching, 60 patients were identified in the MIMVS (study group A) and 58 patients in the median sternotomy (control group B) and compared.\n\n\nSETTING\nA university-affiliated scientific institute, monocentric.\n\n\nPARTICIPANTS\nPatients.\n\n\nINTERVENTIONS\nMitral valve surgery.\n\n\nMEASUREMENTS AND MAIN RESULTS\nNo in-hospital deaths occurred. Aortic cross-clamp time (102 [87.5-119] v 83 [61-109] minutes, p\xa0=\xa00.0001), cardiopulmonary bypass duration (161.5 [142.5-181] v 105.5 [74-134] minutes, p < 0.0001) and intensive care unit stay (47 [44-72] v 45 [40-47] hours, p\xa0=\xa00.0015) were significantly longer in group A. The tricuspid annular plane systolic excursion was not different between group A and group B neither postoperatively (15 ± 3 v 14 ± 4 mm, p\xa0=\xa00.1) nor at three-month follow-up (18 ± 4 v 15 ± 3 mm, p\xa0=\xa00.3). No differences in peak postoperative lactates, inotropic score, central venous pressure, and pulmonary artery pulsatility index were observed. The length of hospital stay was significantly shorter in the minimally invasive group (ten [eight-13] v 12 [ten-17], p\xa0=\xa00.006).\n\n\nCONCLUSION\nThe authors study showed that the surgical strategy had no significant impact on postoperative RV function after mitral valve surgery.