The application of 3D thoracoscope technology in mitral valve surgery

Fu Zhikun; Zhang Xiangli; Wang Licheng; Zhu Yongfeng; Yang Heng; Du Peng; Liu Qi

doi:10.13498/j.cnki.chin.j.ecc.2018.01.06

Abstract：Objective To summarize clinical experience of mitral valve surgery under thoracoscope and conventional thoracotomy mitral valve surgery in the same period and to discuss the application of 3D thoracoscope in mitral valve surgery. Methods Cardiac surgical cases between January 2014 and December 2016 were retrospectively analyzed in our hospital. A total of 35 patients with mitral valve disease underwent treatment of 3D thoracoscope technology during the period including 23 male and 12 female, aged 12-54 (21.2±19.5) years and weighed 32.2-76.5 (40.3±16.4)kg. 13 patients had mitral stenosis, 7 cases with mitral insufficiency, 15 cases with mitral stenosis and insufficiency. The preoperative heart function of 21 cases was under class Ⅱ while 14 cases under class Ⅲ A total of 127 patients underwent conventional surgery, including 53 male and 74 female aged 32-66(47.2±14.6) years with the body weight of 36.2-80.7(65.3±17.9) kg. Mitral stenosis was seen in 42 cases, mitral insufficiency in 23 cases and 62 cases of mitral stenosis and insufficiency.73 patients' preoperative heart function was under class Ⅱ while 54 cases under class Ⅲ. Results No early postoperative death (within 30 days) occurred in thoracoscopic group. Surgical complications were seen in 2.9％ (1/35) of patients. Compared with conventional group, no significant difference was found in extracorporeal circulation time, aorta cross-clamping time, operation duration, postoperative complications and mortality (P＞0.05). Postoperative ICU stay time, drainage volume, red blood cell transfusion, length of hospital stay showed significant difference(P ＜0.05). Patients were followed up for 6-38(10.5±12.7) months when no residual shunt and valvular regurgitation was noted and their cardiac function was class Ⅰ - Ⅱ. Conclusions 3D thoracoscope technology is a safe and reliable minimally invasive option in mitral valve surgery with rapid recovery and good cosmetic effect.