Minimally invasive mitral valve surgery in the old patient
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : L. C. Müller, H. Hangler, J. Kilo, E. Ruttmann-Ulmer, M. Grimm
- چاپ و سال / کشور: 2011
Description
Background: Minimally invasive (MICS) mitral valve surgery has become a valid alternative to the conventional approach by full median sternotomy; nevertheless, it remains unclear if the benefits, which comprehend mainly cosmesis, blood loss, ICU time, hospital stay and return to work also are true for the elderly population and may not be offset by additional complications resulting in an increased morbidity and mortality. Moreover the question remains if the diseases prevailing in the elderly population can be approached by the minimally invasive technique. Methods: Patients 75 years or older treated in our institution from 2001 to 2009 by MICS mitral valve surgery are analyzed in respect to type of surgery (isolated mitral valve surgery or combined with tricuspid or atrial fibrillation surgery), perioperative mortality and intraoperative complications. The results are related to recent literature. Results: Out of 253 MICS mitral valve procedures 30% were performed in patients >70 years, 14% in patients >75 years and 4% in patients of 80 years or older. Mortality was 1.3% in the older age group as compared to 0.8% in the total population. Valve replacement compared to valve repair was not different in the older patients (11% vs. 12.4%). Conclusions: In contrast to aortic valve surgery minimally invasive mitral operations are performed only in a relatively small percentage of elderly patients. According to our results, however, the technique can also be offered to these patients with excellent results. Results from recent literature support this finding. Reduction of surgical trauma not only improves cosmesis, but also is safe in the elderly.
Eur Surg (2011) 43/2: 96–98 DOI 10.1007/s10353-011-0601-2 Received January 5, 2011; accepted after revision January 22, 2011
