La cirugía mínimamente invasiva de la válvula mitral a través de toracotomía derecha es un procedimientoseguro y eficaz a corto y largo plazo. Estudio de cohortes ajustadas por nivelación del riesgo de propensión

Autors de IIS La Fe

• Paula Carmona García

  Autor

• Carlos Luis Errando Oyonarte

  Autor

• Alejandro Vázquez Sánchez

  Autor

• Iratxe Zarragoikoetxea Jauregui

  Autor

Autors aliens a IIS La Fe

• Cánovas, Sergio

Grups d'Investigació

• Anestesia y Cuidados Críticos

  Investigador Principal

  María Azucena Pajares Moncho

• Regeneración y Trasplante Cardíaco

  

  Leader

  Pilar Sepúlveda Sanchis

Abstract

Abstract Introduction: Minimally-invasive mitral valve cardiac surgery has become increasingly popular. The objective of this study is to assess morbidity and efficiency of the technique in the médium run in an initial series. Material and methods: 212 patients underwent mitral valve surgery between 2009 and 2013; 44 with minimally-invasive thoracotomy and 168 via median sternotomy. Statistical pairing was conducted to obtain the control group by means of logistic regression and propensity score matching considering the main risk variables. Morbidity and repair or replacement quality were registered. A univariate and multivariate analysis was carried out for an event comprising morbidity and mortality, efficiency and blood component requirements. Results: Each group included 44 patients. Average follow-up time was 26.6 (14.6) and 28.4 (1.1) months in the study group and control group respectively. Mitral valve repair was performed in 70.5% of patients in the study group and in 68.2% of patients in the control group. No differences were found in perioperative morbidity and mortality. The number of patients who developed moderate or severe mitral insufficiency during follow-up was 9.1% in the study group and 11.4% in the control group (p = 1.0). Minimally-invasive surgery was an independent predictor for lower transfusion in both the univariate and multivariate analyses. Conclusion: Minimally-invasive surgery is not inferior to sternotomy in hospital morbidity or in the quality of surgical technique in an initial program.

Keywords

• Minimally-invasive cardiac surgery; Mitral valve disease; Mitral repair; Morbidity