Cardiac Valve Surgery Via Thoracoscopic Versus Median Sternotomy: A Comparative Study

OBJECTIVE Review and compare the methods and effects of traditional median thoracotomywith thoracoscopy-assisted heart valve (mitral) replacement surgery.METHODS54cases of mitral valve disease patients required mitral valve replacement inaccordance with the wishes of surgery were divided into two groups:39cases of the traditionalmiddle of the thoracotomy group (A): Using the middle of the split sternum, through the ascendingaorta, inferior vena cava to establish cardiopulmonary bypass surgery under direct vision;thoracoscopy-assisted valve replacement group (group B), using the hole-like small incision inchest, through the right femoral artery and vein to establish a close cardiopulmonary bypass,complete the valve replacement under thoracoscopy-assisted. The statistical analysis wasperformed using a series of clinical data of2group patients.RESULTS Surgery went smoothly, no operative deaths, were improved and discharged.Thoracoscopy-assisted valve replacement group during cardiopulmonary bypass total bypass time,aortic cross-clamping time, support time and the time of the surgery longer than traditional middleof the thoracotomy group, and the difference was significant. Compared with traditional surgery,the amount of urine in the transfer of the cardiopulmonary bypass was less (P<0.05), blood losswas slightly more (P <0.05), mechanical ventilation was shorter (P <0.05), during24h pericardialand mediastinal drainage was less (P <0.05), postoperative cardiac intensive care unit stay wasshort (P <0.05), postoperative hospital stay was short (P <0.05).CONCLUSIONS Mitral valve replacement surgery under thoracoscopy-assisted is safe,feasible, minimally invasive, although there are few different in the cardiopulmonary bypassestablished, its influence was no significant. Thoracoscopic-assisted cardiac valve surgery hasunique advantages and is worth promoting.