Comparative Study Of Minimally Invasive Thoracoscopic Mitral Valve Replacement And Traditional Median Thoracotomy Mitral Valve Replacement

Objective: To explore the advantages and disadvantages of thoracoscopic minimally invasive mitral valve replacement surgery and traditional median thoracotomy mitral valve replacement surgery,and to evaluate the safety and efficacy of both,so as to choose more reasonable,safe and effective operation methods for patients.Methods: Retrospective analysis between December 2014 and July 2021 in the diagnosis of mitral valve lesions and mitral valve replacement surgery patients data,40 patients were selected according to enrollment criteria and exclusion criteria and divided into two groups: thoracoscopic group(20 cases)and median thoracotomy group(20 cases).The preoperative basic information,preoperative LV ejection fraction,preoperative LV diameter,total operation time,cardiopulmonary bypass time,ascending aorta time,dossing time,chest closure time,intraoperative bleeding,ventilator assisted breathing time,intensive care stay time,24 hours postoperative flow,drainage extraction time,blood transfusion,proportion of patients with postoperative opioid analgesics,postoperative LV ejection fraction,postoperative left ventricular diameter,postoperative hospitalization days,total hospitalization costs were collected.The conclusions were obtained by performing the statistical analysis of the patient data in both groups.Results: There was no significant difference between patients in thoracoscopy and median thoracotomy group(P>0.05).The median thoracotomy group was significantly better than the thoracoscopy group in total operation time,cardiopulmonary bypass time,aortic blockade time,and total hospitalization cost,and the difference was statistically significant(P<0.05).The thoracoscopic time,intraoperative bleeding volume,ventilator assisted breathing time,ICU stay time,drainage tube extraction time,24 h postoperative induced flow rate,postoperative hospitalization days were better than the median thoracotomy group,and the difference was statistically significant(P<0.05).There was no significant difference in postoperative blood transfusion,postoperative complications and postoperative auxiliary examination between thoracoscopic group and median thoracotomy group(P >0.05).Conclusion: Minimally invasive mitral valve replacement has the same efficacy and feasibility as traditional median thoracotomy mitral valve replacement under thoracoscopy has the advantages of less postoperative pain,less postoperative bleeding,short postoperative hospitalization and less incision,short operation time,short cardiopulmonary bypass time,short aortic blocking time and less hospital cost.