BACKGROUND: Aim of this study is to summarize our experience for almost 662 endoscopic mitral valve surgery and to select best practice.
METHODS: From Jul 2015 to December 2023 662 patient underwent totally endoscopic mitral valve surgery. Exclusion criteria was only severe pulmonary adhesions. We have summarized following features: incision site, endoscope position, atrial retractor position and Chitwood's clamp position, and procedural variables include the repair rate, conversion to sternotomy rate, conversion to direct vision thoracotomy rate and redo for bleeding.
RESULTS: Incision site was 3rd intercostal space in 54% and 4th in 46% of cases. Endoscope position was in 3rd in 43% and 4th in 56 % of cases. Atrial retractor position 3rd 76% cases, 4th in 23% and in remaining in 2nd costal space. Chitwood's clamp position 99 cases was in 2nd space, remaining in 3rd space. Repair rate was 99% on degenerative disease. Conversion on sternotomy rate was 3.2 %. Conversion to direct vision thoracotomy rate was 0.8%. Redo for bleeding was in 2% of cases. Hospital stay in non complicated cases was under 6 days (75% of the cohort). Hospital mortality was 0.2%.
CONCLUSIONS:Endoscopic mitral procedure is safe and reproducible procedure. It proves step learning curve, but gain benefits from hight repair rate, early discharge and excellent cosmic result. Conversion, bleeding and mortality was very low.