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Long-term outcomes of minimally invasive concomitant mitral and tricuspid valve surgery with surgical ablation.
Yoon, Sungsil; Kim, Kitae; Yoo, Jae Suk; Kim, Joon Bum; Chung, Cheol Hyun; Jung, Sung-Ho.
Afiliación
  • Yoon S; Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
  • Kim K; Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Yoo JS; Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Kim JB; Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Chung CH; Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Jung SH; Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Interdiscip Cardiovasc Thorac Surg ; 39(3)2024 Sep 04.
Article en En | MEDLINE | ID: mdl-39186012
ABSTRACT

OBJECTIVES:

We compared the outcomes of a right mini-thoracotomy (RMT) versus those of a sternotomy for concomitant mitral and tricuspid valve surgery and surgical ablation.

METHODS:

We analysed patients who underwent concomitant mitral and tricuspid valve surgery and surgical ablation at a single institution (mean follow-up 7 years) after propensity score matching. The primary and secondary outcomes were all-cause death, composite major adverse events (including stroke, reoperation, readmission, permanent pacemaker insertion) and recurrence of atrial fibrillation (A-fib). A subgroup analysis was performed.

RESULTS:

A total of 797 procedures (mean age 61.6 years; RMT 45.2%; female 66.5%; mitral valve repair 33.6%) were done; 267 pairs were matched. The 5- and 10-year overall survival in the matched cohort was 92.7% and 86.9% for the RMT group and 92.1% and 83.1% for the sternotomy group (P = 0.879). Significant differences were not observed in major adverse events (P = 0.273; hazard ratio 0.76) and A-fib recurrence (P = 0.080; hazard ratio 0.72). The RMT group had lower rates of postoperative low cardiac output syndrome (P = 0.019) and acute renal failure (P = 0.003). Atrial fibrillation high-risk factors (including long-standing A-fib, enlarged left atrium, old age) exhibited significant interactions (P for interaction = 0.002) with the approach regarding A-fib recurrence.

CONCLUSIONS:

In this study, an RMT exhibited no significant differences in long-term outcomes compared to a sternotomy, but it could remain a clinically reasonable option. Patients with a high risk of A-fib may have favourable ablation outcomes with a sternotomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Interdiscip Cardiovasc Thorac Surg Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Interdiscip Cardiovasc Thorac Surg Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido