Objective : To assess the advantage of Port-Access Surgery (PAS) for mitral and/or tricuspid surgery after previous cardiac surgery.
Methods : Prospective data collection of all mitral and/or tricuspid PAS from February 1997 until December 2002.
Results : In a 6-year period 410 patients did undergo mitral and/or tricuspid surgery through PAS. Fourtheen pts (3.4%) had previous cardiac surgery; 1st redo: n=8, 2nd redo : n=4, 3th redo : n=1, 4th redo : n=1. Mean age was 64.9 13.1 years and 8 pts were female. Previous mitral/tricuspid surgery in 5 pts, congenital surgery in 3 pts, combined CABG and mitral surgery in 2 pts, CABG in 3 pts and hearttransplantation in 1 pt.
MVR was performed in 4 pts, MV repair in 5 pts and repair of paravalvular leak in 2 pts. MV repair with TV surgery in 2 pts and TVR in one pt. Associated minimaze was performed in 3 pts. There was no conversion to sternotomy and no re-exploration for bleeding.
| Operative characteristics (mean) | |
| Operating time | 4 hours 14 minutes + 1h14 |
| ECC time | 141.5 minutes + 49.4 |
| Cross Clamp time | 85.9 minutes + 29.4 |
No early mortality occurred. There was one respiratory failure.
| Postoperative characteristics (mean) | |
| ICU stay | 72.9 hours |
| Ventilation time | 23.9 hours |
| Bloodloss | 1002 cc |
| Hospital stay | 13.4 + 8.3 days |
The mean late follow-up was 23 months, there was n° 1 late mortality in the HTX patient, no major valve related morbidity
Conclusions : In our institution Port-Access Surgery has become the standard approach for redo mitral and/or tricuspid surgery. Our initial experience demonstrated extremely low morbidity and no mortality in a high risk subset of patients.