Abstract
Background Minimally invasive extracorporeal circulation (MECC) technology was applied predominantly
in coronary surgery. Data regarding the application of MECC in minimally invasive
valve surgery are missing largely.
Patients and Methods Patients undergoing isolated minimally invasive mitral or aortic valve procedures
were allocated either to conventional extracorporeal circulation (CECC) group (n = 63) or MECC group (n = 105), and their prospectively generated data were analyzed.
Results Demographic data were comparable between the groups regarding age (CECC vs. MECC:
71.0 ± 7.5 vs. 66.2 ± 10.1 years, p = 0.091) and logistic EuroSCORE I (6.2 ± 2.5 vs. 5.4 ± 3.0, p = 0.707). Hospital mortality was one patient in each group (1.6 vs. 1.0%, p = 0.688). The levels of leukocytes were lower in the MECC group (11.6 ± 3.2 vs. 9.4 ± 4.3
109/L, p = 0.040). Levels of platelets (137.2 ± 45.5 vs. 152.4 ± 50.3 109/L, p = 0.015) and hemoglobin (103.3 ± 11.3 vs. 107.3 ± 14.7 g/L, p = 0.017) were higher in the MECC group. Renal function was better preserved (creatinine:
1.1 ± 0.4 vs. 0.9 ± 0.2 mg/dL, p = 0.019). We were able to validate shorter time of postoperative ventilation (9.5 ± 15.1
vs. 6.3 ± 3.4 h, p = 0.054) as well as significantly shorter intensive care unit (ICU) stay (1.8 ± 1.3
vs. 1.2 ± 1.0 d, p = 0.005) for MECC patients. The course of C-reactive protein did not differ between
the groups.
Conclusion We were able to prove the feasibility of MECC even in minimally invasive performed
mitral and aortic valve procedures. In addition, the use of MECC provides decreased
platelet consumption and less hemodilution. The use of MECC in these selected patients
lead to a shorter ventilation time and ICU stay.
Keywords
aorta/aortic - cardiopulmonary bypass - cardiac valve surgery - minimally invasive
surgery - mitral valve procedure - perfusion
