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A Prospective Study To Evaluate Minimally Invasive Right Thoracotomy Versus Conventional Sternotomy Approach For Mitral Valve Repair in Rheumatic Patients.
Shamsher S. Lohchab.
PGIMS, Rohtak, India.

Objective : This study was planned to evaluate the feasibility of mitral valve repair through minimally invasive right anterolateral thoracotomy approach and compare the outcomes with conventional sternotomy approach. Method : From May 2012 to October 2013,25 patients underwent mitral valve repair through limited right anterolateral thoracotomy (Group 1). Various clinical outcome parameters were compared with a 25-patient (Group 2) sternotomy. The age and sex distribution in two groups were comparable. All patients in both groups were having similar spectrum of RHD and functional status. Different repair techniques were used with rigid ring annuloplasty.TEE was used. Results: There was no operative mortality. Clinical parameters were better with group1compared to group 2, like ICU stay (68.84 hrs vs 88.82 hrs),hospital stay (5.4 days vs 9.5 days),chest tube drainage (375.60ml vs 536.5 ml),chest tube removal (55.96 hrs vs 65.78 hrs),incision length 7.4 cm vs 14.2 cm). Cross clamp time and bypass time were higher in group 1.Superficial groin wound discharge was in one in group 1. Outcome in term of mitral valve function was comparable (significant MS ,MR 4%,0% group 1 vs4%,4% group2 at maximum follow up of 18 months.
 Conclusion : Mitral valve repair is feasible and safe with minimally invasive thoracotomy approach with equivalent functional results and is better with respect to cosmesis,incision length, ICU stay,hospital stay,early mobility and patient satisfaction compared to sternotomy.

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