Đánh giá kết quả phẫu thuật thay van hai lá bằng phương pháp ít xâm lấn tại Bệnh viện Trung ương Huế

Abstract

Background: Minimally invasive cardiac surgery has been worldwidely and powerfully developed in both quantity and quality. In Vietnam, at Hue Central Hospital, we have recently performed minimally invasive surgical techniques in mitral valve replacement with promising outcomes. Objective: To evaluate the early outcomes of minimally mitral valve replacement (MIMVR) surgery via the right thoracotomy in our department. Subject and method: This is a descriptive study. All patients were diagnosed as mitral stenosis and mitral regurgitation, and underwent MIMVR at Hue Central Hospital from December 2016 to December 2019. Patients were postoperatively followed up and assessed by clinical examination and echocardiography within 3 months. Result: 56 patients underwent MIMVR surgery, the male-female ratio was 1: 2.1; the mean age was 44.5 ± 12.5 years old; Preoperative functional symptom: NYHA grade I-II in 66.1%. Mean MVA was 1 ± 0.6cm²; mean LVEF was 63.2 ± 5.4%; mean PAPs was 43.3 ± 18.3mmHg. Mean aortic cross-clamping and mean CPB time time was 95.8 ± 16.6 minutes and 130.2 ± 27.9 minutes respectively; mean mechanical ventilation time was 3.4 ± 1.3 hours; mean ICU time was 5.9 ± 1.8 days. No hospital death; 3.6% of postoperative bleeding needed
re-operation. The mean VAS score of the 2^nd day was 2.9 ± 0.8 and of 3^rd day was 2.2 ± 0.8. In a 3 month follow-up, 73.6% were NYHA grade I - II; mean LVEF was 62.9 ± 3.7%; mean PAPs was 31.7 ± 3.7mmHg; there were no re-operation needed and no mortality during the following time. Conclusion: MIMVR surgery at Hue Central Hospital was safe and effective, significantly improved clinical symptoms as well as postoperative pain.