Preoperative and operative characteristics
A total of 410 patients underwent MVr during the study period. A small
right anterior thoracotomy was performed in 275 patients (RAT group),
while 135 had a standard median sternotomy (ST group).
Preoperative characteristics are shown in Table 1 . There were
no differences between groups in gender, race, body mass index, New York
Heart Association classification, preexisting atrial fibrillation,
congestive heart failure, hyperlipidemia, hypertension, chronic
obstructive pulmonary disease, renal disease, or previous stroke or
myocardial infarction. RAT patients were significantly younger, had
slightly higher ejection fractions, were less likely to have had
previous cardiac surgery, and more likely to have posterior MV leaflet
involvement, severe mitral regurgitation, and a degenerative etiology of
MV disease.
Operative data is presented in Table 2. Significant differences
were seen between groups for multiple variables. As compared to the ST
group, the RAT group had shorter cross clamp and cardiopulmonary bypass
times, however, the ST group was significantly more likely to have a
concomitant cardiac surgery procedure at the time of MVr. There were
also differences in locations of MVrs, with more posterior repairs in
the RAT group and more anterior repairs the ST group. There was one
conversion to full sternotomy in the RAT group.