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Ann Thorac Surg. 2011 Feb;91(2):406-10. doi: 10.1016/j.athoracsur.2010.09.039.

Outcomes of minimally invasive valve surgery versus standard sternotomy in obese patients undergoing isolated valve surgery.

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  • 1Columbia University Division of Cardiology, Miami Beach, Florida, USA. osantana@msmc.com

Abstract

BACKGROUND:

We hypothesize that composite in-hospital surgical complications are lower in obese patients who undergo minimally invasive valve surgery for aortic and (or) mitral valve disease, when compared with the standard median sternotomy approach.

METHODS:

We retrospectively reviewed 2,288 heart operations done at our institution between January 3, 2005 and January 10, 2010, and identified 160 consecutive obese patients, defined as patients with a body mass index of greater than 30 kg/m(2), who underwent isolated mitral and (or) aortic valve surgery. The outcomes of those who had minimally invasive valve surgery were compared with a matched control group who had valve surgery through a median sternotomy approach.

RESULTS:

Of the 160 patients, 64 underwent the minimally invasive approach and 96 had a median sternotomy. The mean age was 69.4 ± 11 years for the minimally invasive group, and 64.7 ± 11.5 for the median sternotomy group (p = 0.015). Composite postoperative complications occurred in 15 (23.49%) versus 49 (51.0%) patients (p = 0.034) in the minimally invasive group versus median sternotomy, respectively. The difference was driven by a lower incidence of acute renal failure (0 vs 6 patients [6.25%], p = 0.041), prolonged intubation (12 [18.7%] vs 33 [34.3%], p = 0.049), reintubation (3 [4.68%] vs 15 [15.6%], p = 0.032), deep wound infections (0 vs 4 [4.1%], p = 0.098), and death (0 vs 8 [8.3%], p = 0.041), respectively. All patients in the minimally invasive group were alive at 30 days.

CONCLUSIONS:

Minimally invasive surgery for isolated valve lesions in obese patients has a lower morbidity and mortality when compared with the standard median sternotomy approach.

Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

PMID:
21256280
[PubMed - indexed for MEDLINE]
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