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Eur J Cardiothorac Surg. 2012 Oct;42(4):648-52. doi: 10.1093/ejcts/ezs098. Epub 2012 May 3.

Outcomes of minimally invasive valve surgery in patients with chronic obstructive pulmonary disease.

Author information

1
Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL 33140, USA. osantana@msmc.com

Abstract

OBJECTIVES:

We hypothesize that minimally invasive valve surgery in patients with chronic obstructive pulmonary disease (COPD) is superior to the conventional median sternotomy approach.

METHODS:

We retrospectively reviewed 2846 consecutive surgery performed at our institution between January 2005 and September 2010, and identified 165 patients with COPD who underwent isolated valve surgery. In-hospital mortality, composite complication rates, intensive care unit and total hospital length of stay of those who had undergone a minimally invasive approach were compared with a cohort that underwent a standard median sternotomy approach.

RESULTS:

Of the 165 patients, 100 underwent a minimally invasive approach and 65 had a median sternotomy. Baseline characteristics did not differ between the two groups. The mean age was 71 ± 11 years for the minimally invasive group and 68 ± 12 years for the median sternotomy group, (P = 0.31). In-hospital mortality was 1 (1%) in the minimally invasive group and 3 (5%) in the median sternotomy group, P = 0.14. Composite postoperative complications were significantly reduced in the minimally invasive group (30 versus 54%, P = 0.002). The median intensive care unit length of stay was 47 h (IQR 40-70) versus 73 h (IQR 51-112), P < 0.001, and the median postoperative length of stay was 6 days (IQR 5-9) versus 9 days (IQR 7-13), P < 0.001, for the minimally invasive and the median sternotomy groups, respectively.

CONCLUSIONS:

Minimally invasive valve surgery in patients with COPD is associated with excellent short-term results, and thus should be considered an option in these patients.

PMID:
22555309
DOI:
10.1093/ejcts/ezs098
[Indexed for MEDLINE]

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