Mitral Valve and Atrial Septal Defect Surgery - Minimally Invasive or Sternotomy Approach

Background: To decrease the surgical trauma in heart procedures, minimally invasive (MI) techniques were alternatively introduced. Objective: To compare MI surgical access with median sternotomy (MS) for the treatment of mitral valve (MV) disease and atrial septal defect (ASD). Methods: Forty patients underwent surgery for correction of MV disease or ASD. Patients were divided into group A (GA) (n = 20), access by right minithoracotomy and video-assistance; and group B (GB) (n = 20), access by full MS. Aortic cross-clamp and cardiopulmonary bypass time, intensive care unit (ICU) time, hospital stay and morbidity were compared in this prospective study. Results: Fifteen patients were submitted to MV procedures and five to ASD corrections in each group. There were 9 mitral replacements (7 bioprostetic and 2 mechanical) and 6 repairs in GA, and 10 (all bioprostetic) and five in GB. The mean aortic cross-clamp and cardiopulmonary bypass time, in minutes, were 65.1 +/- 29.3 in GA and 50.2 +/- 21.4 in GB (p = 0.074); and 91.8 +/- 35 in GA and 63.7 +/- 27.3 in GB (p = 0.008). The mean ICU time, in hours, were 51.7 +/- 16.3 in GA and 55.8 +/- 17.5 in GB (p = 0.45). The in hospital stay, in days, were 5.2 +/- 1 in GA and 6.4 +/- 1.5 in GB (p = 0.009). Conclusion: MI access for correction of the MV disease and ASD implicated in a longer cardiopulmonary bypass time for finalization of the main procedure, nevertheless it didn't affect patient's recuperation. MI treated patients were discharged earlier than sternotomy treated patients. (Arq Bras Cardiol 2012;99(2):681-687)