Minimally invasive valve operations

Background. To reduce the morbidity from valvular heart operations, a right parasternal approach was introduced. We report our initial experience with the procedure. Methods. From January 1996 through July 1996, 115 patients underwent primary isolated valve procedures. One hundred (85%) patients underwent the operation through a right parasternal incision. Results. There was one hospital death secondary to a stroke on the fifth postoperative day. Three patients (two with aortic valve operations and one having a mitral valve procedure) required conversion to sternotomy. Mean aortic occlusion time was 71 minutes; mean cardiopulmonary bypass time was 93 minutes. Mean stay in the intensive care unit was 27 hours and mean hospital postoperative stay was 5.7 days. Seventy-seven percent of the patients did not receive blood transfusions. Comparison with median sternotomy demonstrated a reduction in both postoperative length of stay and direct hospital costs. Conclusions. We conclude that this minimally invasive approach is safe for a variety of valve procedures and is effective in reducing surgical trauma and cost. (C) 1998 by The Society of Thoracic Surgeons.