Early clinical outcomes of thoracoscopic valve surgery with 1188 consecutive cases in a single center

DONG Shi-yong; ZHANG Lin; LI Dong; CHENG Nan; LI Liang-gang; SHEN Hua; HE Xiao-yi; JIANG Sheng-li

doi:10.3969/j.issn.1672-5301.2025.04.008

Abstract：Objective To report our experience of 1188 consecutive cases of thoracoscopic valve surgery performed by a single team,and to evaluate perioperative safety and feasibility of the procedure.Methods From September 2017 to December 2024,1188 patients who underwent thoracoscopic valve surgery in Department of Cardiovascular Surgery,the 1st Medical Centre,Chinese PLA General Hospital by a single operation team were included in this retrospective study.The clinical data including baseline and perioperative information were collected.Results There were 582 males and 606 females enrolled,and the mean age was 55.6±15.5 years old,ranging from 9 to 86 years old.In this consecutive series of 1188 patients,849(71.5％)patients received thoracoscopic mitral valve surgery;93(7.8％)patients received thoracoscopic aortic valve surgery;210(17.7％)patients received isolated tricuspid valve surgery;34(2.9％)patients received thoracoscopic modified Morrow procedure and mitral valve surgery;2(0.2％)patients received thoracoscopic aortic valve replacement(AVR)and mitral valve repair(MVP).Redoing thoracoscopic valve surgeries were performed in 261(22.0％)patients,including mitral valve reoperation with hypothermia-induced ventricular fibrillation arrest in 87 patients and tricuspid valve operation after left-sided valve surgery in 174 patients.Conversion rate was 1.2％(14 patients),perioperative mortality was 0.9％(11 patients).Postoperative mechanical ventilation ranged 12(8-18)hours.9(0.8％)patients received extracorporeal membrane oxygenation(ECMO)implantation,and 17(1.4％)patients received intra-aortic balloon pump(IABP)implantation due to low cardiac output syndrome(LCOS).Newly developed stroke,atrial fibrillation(AF),and dialysis were observed in 12(1.0％),25(2.1％)and 23(1.9％)patients,respectively.21(1.8％)patients were extubated after 72 h postoperatively.10(0.8％)patients received reoperation during hospitalization due to bleeding(8 patients)or valvular malfunction(2 patients).Conclusion Thoracoscopic valve surgery can be performed by experienced team in high-volume center for various types of valvular disease.The procedure is technically feasible,safe and reproducible.The perioperative result is satisfactory.