Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study
Abstract Background Minimally invasive mitral valve surgery has been introduced as a safe alternative to full sternotomy through smaller chest wall incisions to reduce the potential sternal complications in addition to the favorable aesthetic effect. This observational study has been designed to eva...
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SpringerOpen
2025-02-01
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| Series: | The Cardiothoracic Surgeon |
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| Online Access: | https://doi.org/10.1186/s43057-025-00150-8 |
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| author | Gehad Awad Fetoh Alaaeldin Fetoh Noureldin Noaman Gwely Usama Hamza Sameh Amer Yomna Mohammed Yehya Amr Abdellateef |
| author_facet | Gehad Awad Fetoh Alaaeldin Fetoh Noureldin Noaman Gwely Usama Hamza Sameh Amer Yomna Mohammed Yehya Amr Abdellateef |
| author_sort | Gehad Awad |
| collection | DOAJ |
| description | Abstract Background Minimally invasive mitral valve surgery has been introduced as a safe alternative to full sternotomy through smaller chest wall incisions to reduce the potential sternal complications in addition to the favorable aesthetic effect. This observational study has been designed to evaluate and compare operative and short-term postoperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement. The study was conducted on 40 cases and divided into two groups: group 1, comprised of 20 patients who underwent video-assisted mitral valve replacement (VAMVR), and group 2, comprised of 20 patients who underwent right anterior mini-thoracotomy mitral valve replacement (ATMVR). Preoperative data, intraoperative procedures, and early postoperative results have been compared between both techniques. Results Intraoperative parameters showed no statistical difference between the two groups. Wound length in the VAMVR group was statistically smaller than the ATMVR group, 5.33 ± 0.96 cm versus 7.08 ± 1.24 cm, respectively (P < 0.001). The intraoperative assessment by TEE showed a well-suited, well-functioning prosthetic valve, and no paravalvular leak in the two groups. In both groups, there were statistically significant reductions in left ventricular end diastole, left atrial diameter, and pulmonary artery systolic pressure in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). There was a statistically significant decrease in left ventricular end-systole in the VAMVR group in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). ICU visual analog scale (VAS) was significantly lower in the VAMVR group than in the ATMVR group (P = 0.049). There was a gradual reduction in VAS in both groups along the period of 3 months postoperatively without significant differences between the two groups in 2 weeks and 3 months postoperatively. Conclusions VAMVR and ATMVR could be considered safe, feasible approaches with favorable perioperative surgical and echocardiographic results. VAMVR showed statistically significant smaller wounds and less postoperative pain than ATMVR, which may offer potential advantages in terms of reduced postoperative discomfort and cosmetic appearance for the thoracoscopic technique. Further randomized studies with larger cohorts and longer follow-ups are recommended to evaluate the long-term benefits and safety of both techniques. |
| format | Article |
| id | doaj-art-12ed73fe037045b8aaa35d3e713f19d6 |
| institution | Kabale University |
| issn | 2662-2203 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SpringerOpen |
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| series | The Cardiothoracic Surgeon |
| spelling | doaj-art-12ed73fe037045b8aaa35d3e713f19d62025-02-09T12:54:44ZengSpringerOpenThe Cardiothoracic Surgeon2662-22032025-02-0133111010.1186/s43057-025-00150-8Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational studyGehad Awad0Fetoh Alaaeldin Fetoh1Noureldin Noaman Gwely2Usama Hamza3Sameh Amer4Yomna Mohammed Yehya5Amr Abdellateef6Faculty of Medicine, Cardiothoracic Surgery Department, Cardiothoracic and Vascular Surgery Center, Mansoura UniversityFaculty of Medicine, Cardiothoracic Surgery Department, Cardiothoracic and Vascular Surgery Center, Mansoura UniversityFaculty of Medicine, Cardiothoracic Surgery Department, Cardiothoracic and Vascular Surgery Center, Mansoura UniversityFaculty of Medicine, Cardiothoracic Surgery Department, Cardiothoracic and Vascular Surgery Center, Mansoura UniversityFaculty of Medicine, Cardiothoracic Surgery Department, Cardiothoracic and Vascular Surgery Center, Mansoura UniversityFaculty of Medicine, Medical Physiology Department, Mansoura UniversityFaculty of Medicine, Cardiothoracic Surgery Department, Cardiothoracic and Vascular Surgery Center, Mansoura UniversityAbstract Background Minimally invasive mitral valve surgery has been introduced as a safe alternative to full sternotomy through smaller chest wall incisions to reduce the potential sternal complications in addition to the favorable aesthetic effect. This observational study has been designed to evaluate and compare operative and short-term postoperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement. The study was conducted on 40 cases and divided into two groups: group 1, comprised of 20 patients who underwent video-assisted mitral valve replacement (VAMVR), and group 2, comprised of 20 patients who underwent right anterior mini-thoracotomy mitral valve replacement (ATMVR). Preoperative data, intraoperative procedures, and early postoperative results have been compared between both techniques. Results Intraoperative parameters showed no statistical difference between the two groups. Wound length in the VAMVR group was statistically smaller than the ATMVR group, 5.33 ± 0.96 cm versus 7.08 ± 1.24 cm, respectively (P < 0.001). The intraoperative assessment by TEE showed a well-suited, well-functioning prosthetic valve, and no paravalvular leak in the two groups. In both groups, there were statistically significant reductions in left ventricular end diastole, left atrial diameter, and pulmonary artery systolic pressure in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). There was a statistically significant decrease in left ventricular end-systole in the VAMVR group in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). ICU visual analog scale (VAS) was significantly lower in the VAMVR group than in the ATMVR group (P = 0.049). There was a gradual reduction in VAS in both groups along the period of 3 months postoperatively without significant differences between the two groups in 2 weeks and 3 months postoperatively. Conclusions VAMVR and ATMVR could be considered safe, feasible approaches with favorable perioperative surgical and echocardiographic results. VAMVR showed statistically significant smaller wounds and less postoperative pain than ATMVR, which may offer potential advantages in terms of reduced postoperative discomfort and cosmetic appearance for the thoracoscopic technique. Further randomized studies with larger cohorts and longer follow-ups are recommended to evaluate the long-term benefits and safety of both techniques.https://doi.org/10.1186/s43057-025-00150-8Minimally invasive surgeryMitral valve replacementThoracoscopic surgery |
| spellingShingle | Gehad Awad Fetoh Alaaeldin Fetoh Noureldin Noaman Gwely Usama Hamza Sameh Amer Yomna Mohammed Yehya Amr Abdellateef Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study The Cardiothoracic Surgeon Minimally invasive surgery Mitral valve replacement Thoracoscopic surgery |
| title | Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study |
| title_full | Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study |
| title_fullStr | Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study |
| title_full_unstemmed | Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study |
| title_short | Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study |
| title_sort | perioperative outcomes of video assisted versus right anterior thoracotomy mitral valve replacement an observational study |
| topic | Minimally invasive surgery Mitral valve replacement Thoracoscopic surgery |
| url | https://doi.org/10.1186/s43057-025-00150-8 |
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