Surgery for heart valve disease and cardiac tumors via mini-thoracotomy: experience of 300 interventions

Objective. To evaluate the effectiveness and safety of surgery for heart valve disease and cardiac tumors via right-sided anterior minithoracotomy. Material and methods. A retrospective analysis included 309 patients with heart valve disease, atrial septal defects and cardiac tumors. All patients underwent correction of defect or removal of neoplasm via right-sided minithoracotomy. Results. In early postoperative period, there was 1 (0.3%) dearth due to left ventricular rupture. Mean surgery time was 191 min [171; 218], cardiopulmonary bypass time — 91 min [77; 110], aortic cross-clamping time — 69 min [63; 82], intraoperative blood loss — 450 ml [400; 500]. Conversion to sternotomy was performed in 7 (2.3%) cases. Mechanical ventilation time was 4.5 hours [3; 6], ICU-stay — 1 day, postoperative hospital-stay — 7 days [6; 8]. Conclusion. Correction of valvular and structural defects, as well as cardiac tumor removal via minithoracotomy is reproducible and effective. These procedures are associated with low mortality, good cosmetic outcomes and preservation of chest wall function. Correction of mitral valve disease through min-thoracotomy in early phase of technique development was associated with prolonged surgery, cardiopulmonary bypass and aortic cross-clamping.