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Pulmonary hypertension: aortic and/or mitral valve surgery performed via a minimally invasive approach


Pulmonary hypertension ( PH ) in the setting of left-sided valvular heart disease is common, and significantly increases the risk of perioperative morbidity and mortality in patients undergoing aortic and/or mitral valve surgery.

Minimally invasive valve surgery is associated with a decreased incidence of perioperative complications, and a faster recovery, when compared with conventional sternotomy.

In a study, the outcomes of 569 patients with pulmonary hypertension who underwent minimally invasive aortic and/or mitral valve surgery were analysed.

The operative mortality was 3.5%, and postoperative strokes occurred in 1.4%.

The mean intensive care unit and hospital length of stays were 50 ± 14 h and 7 ± 1 days, respectively.

Patients with severe PH ( mean pulmonary artery pressure greater than or equal to 40 mmHg ) had a longer duration of postoperative ventilation and intensive care unit length of stay, when compared with mild / moderate pulmonary hypertension, and similar clinical outcomes.

In conclusion, a minimally invasive approach to aortic and/or mitral valve surgery in patients with pulmonary hypertension is safe and feasible, and may be considered as an alternative to conventional median sternotomy. ( Xagena )

Gosain P et al, Interact Cardiovasc Thorac Surg 2016; Epub ahead of print

XagenaMedicine_2016



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