Comparative Evaluation Of Minimally Invasive Right Anterolateral Thoracotomy With Conventional Sternotomy For Mitral Valve Replacement.

Abstract

 Objectives: The aims and objectives of this study were to compare and analyze the results of right anterolateral thoracotomy and median sternotomy approach for a primary mitral valve replacement with reference to:

• Time taken to complete the surgery
• Mean bypass time
• Mean cross clamp time
• Mean post operative bleeding
• Mean hours of mechanical ventilation
• Hospital stay
• Post operative pain.
• Cosmesis
• Time taken to start normal life activity
• NYHA class after three months

Study design: Prospective study was done from September 2018 to April 2021. The patients will be followed for a period of 18 months.

Results and conclusion: Thoracotomy is a better approach for mitral valve replacement than sternotomy and is safe also in experience hands.

Total surgical time is significantly less in the case of thoracotomy than sternotomy while Bypass time and cross-clamp time in thoracotomy are comparable with sternotomy. Mechanical ventilation time, post-op bleeding, hospital stay, and post-operative pain in thoracotomy are significantly lesser than in sternotomy and the mitral valve approach through a right anterolateral thoracotomy is easy to perform and is having better cosmetic result especially in female patients.