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Delos M. Cosgrove, III
Joseph F. Sabik
José L. Navia
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Ann Thorac Surg 1998;65:1535-1538
© 1998 The Society of Thoracic Surgeons

Original articles: cardiovascular

Minimally Invasive Valve Operations

Delos M. Cosgrove, III, MDa, Joseph F. Sabik, MDa, José L. Navia, MDa

a Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Address reprint requests to Dr Cosgrove, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation (F25), 9500 Euclid Ave, Cleveland, OH 44195

Presented at the Thirty-third Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Feb 3–5, 1997.

Background. To reduce the morbidity from valvular heart operations, a right parasternal approach was introduced. We report our initial experience with the procedure.

Methods. From January 1996 through July 1996, 115 patients underwent primary isolated valve procedures. One hundred (85%) patients underwent the operation through a right parasternal incision.

Results. There was one hospital death secondary to a stroke on the fifth postoperative day. Three patients (two with aortic valve operations and one having a mitral valve procedure) required conversion to sternotomy. Mean aortic occlusion time was 71 minutes; mean cardiopulmonary bypass time was 93 minutes. Mean stay in the intensive care unit was 27 hours and mean hospital postoperative stay was 5.7 days. Seventy-seven percent of the patients did not receive blood transfusions. Comparison with median sternotomy demonstrated a reduction in both postoperative length of stay and direct hospital costs.

Conclusions. We conclude that this minimally invasive approach is safe for a variety of valve procedures and is effective in reducing surgical trauma and cost.






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