Does endoaortic balloon occlusion compared to transthoracic aortic clamp improve outcomes and reduce major complications in patients undergoing minimally invasive mitral valve surgery?
Both transthoracic aortic clamp and endoaortic balloon occlusion are safe for minimally invasive mitral valve surgery, though EAO may offer technical advantages in redo operations despite a non-significant trend toward higher stroke rates.
BACKGROUND: Minimally invasive cardiac surgery has increasingly been used for patients with valvular pathology. Two techniques of aortic occlusion are utilized with this technique: transthoracic aortic clamp (TTC) and endoaortic balloon occlusion (EAO). Both possibilities present peculiar advantages and limitations whose current evidence is based on few observational studies. We performed an analysis with the primary objective to evaluate outcomes and the incidence of major complications of these two techniques. METHODS: The data of 258 patients who underwent minimally invasive mitral valve surgery through right mini-thoracotomy from January 2013 to July 2018 were reviewed. One hundred sixty-five patients were operated on with TTC and in 93 cases EAO was used. Univariate and multivariate analyses were performed to identify predictors of adverse outcome. RESULTS: EAO 1.1%; P=0.61). CONCLUSIONS: Both techniques proved to be safe. Although non-statistically significant, there was a higher rate of cerebral stroke in the EAO group. However, EAO system shows technical advantages in avoiding tissue dissection and remains our choice in redo operations.
Margari et al. (Thu,) studied this question.