Minimally Invasive Video-assisted Mitral Valve Replacement with a Right Chest Small Incision in Patients Aged Over 65 Years

Abstract Objective: To analyze and summarize the clinical safety and feasibility of minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision in patients aged over 65 years. Methods: The clinical data of 45 patients over 65 years old who had mitral valve disease were analyzed retrospectively from January 2014 to January 2017 at Union Hospital, Fujian Medical University. The patients were divided into two groups; 20 patients in group A, who underwent minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision, and 25 patients in group B, who underwent conventional mitral valve replacement. We collected and analyzed their relevant clinical data. Results: The operation was completed successfully in both groups. Compared with group B, group A was clearly superior for postoperative analgesia time, postoperative hospital length of stay, thoracic drainage liquid, blood transfusion, and length of incision. There were no differences between the two groups in postoperative severe complications and mortality. More patients in group B had pulmonary infections and poor incision healing, while more patients in group A had postoperative pneumothorax and subcutaneous emphysema. Conclusion: In patients aged over 65 years, minimally invasive video-assisted mitral valve replacement with a small incision in the right chest had the same clinical safety and efficacy as the conventional method.

摘要 目的：分析并总结65岁以上患者经右胸小切口行微创视频辅助二尖瓣置换术（minimally invasive video-assisted mitral valve replacement via a right thoracic minimal incision）的临床安全性与可行性。方法：回顾性分析2014年1月至2017年1月福建医科大学附属协和医院收治的45例65岁以上二尖瓣疾病患者的临床资料，将患者分为两组：A组20例，接受右胸小切口微创视频辅助二尖瓣置换术；B组25例，接受传统二尖瓣置换术。收集并分析两组患者的相关临床数据。结果：两组手术均顺利完成。与B组相比，A组在术后镇痛时长、术后住院时长、胸腔引流量、输血量及切口长度方面均显著更优。两组术后严重并发症发生率及死亡率无明显差异。B组肺部感染、切口愈合不良的患者更多，而A组术后气胸及皮下气肿的患者更多。结论：对于65岁以上患者，右胸小切口微创视频辅助二尖瓣置换术与传统术式具有相当的临床安全性与有效性。