Mustafa Mert Özgür1, Halil İbrahim Bulut2, Tanıl Özer1, Mehmet Aksüt1, Anıl Güzeloğlu1, Mehmet Kaan Kırali1

1Clinic of Cardiovascular Surgery, Koşuyolu High Specialization Training and Research Hospital, İstanbul, Türkiye
2Student at Cerrahpaşa University Faculty of Medicine, İstanbul, Türkiye

Keywords: Thoracotomy; MICS; MVR; mitral repair


Introduction: Surgical treatment of structural heart diseases continues to predominantly involve median sternotomy, despite the ongoing trends favoring minimally invasive approaches that have persisted for many years. In this study, we present data on structural heart disease (SHD) surgeries conducted by our institute using a right mini-thoracotomy approach.

Patients and Methods: This single-center retrospective study included 58 patients who underwent right minithoracotomy procedures between February 2018 and June 1, 2023. Preoperative demographic and medical data were collected from patient files and records. Perioperative and 30-day outcome data were obtained through the national electronic record system.

Results: The average age of the participants was 39.9. Female patients accounted for 31.6% (n= 18) of the participants. The majority of surgeries in this study involved peripheral cannulation and conventional cardioplegia. Mitral valve repair and atrial septal defect closure were the most common procedures performed. Intraoperative outcomes showed favorable results, with no instances of significant bleeding, structural complications, or mortality. Regarding the postoperative 30-day outcomes, the stroke rate was 1.8% (n= 1) among the patients. There were no reported cases of transient ischemic attack (TIA), myocardial infarction (MI), and mortality. The conversion to median sternotomy occurred in 3.4% (n= 2) of the cases. Reoperation and reexploration were required in 1.8% (n= 1) of the cases. The mean length of stay in the ICU was 1.7 days, while the mean length of ward stay was 4.2 days.

Conclusion: This study contributes to the evidence supporting the shift towards minimally invasive approaches in the surgical management of structural heart disease. The low rate of intraoperative conversion, absence of major complications, and favorable postoperative outcomes highlight the safety and feasibility of right mini-thoracotomy. Continued advancements in surgical techniques and clinical expertise are expected to further optimize patient outcomes and improve the quality of care in this field.

Cite this article as: Özgür MM, Bulut Hİ, Özer T, Aksüt M, Güzeloğlu A, Kırali MK. Right mini-thoracotomy in the surgical treatment of structural heart diseases (SHDs): An institutional experience. Koşuyolu Heart J 2023;26(3):121-127.

Ethics Committee Approval

This study was approved by the Kartal Koşuyolu High Specialization Training and Research Hospital Ethics Committee (Decision no: 2023/11/702, Date: 04.07.2023).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - MMÖ; Analysis/Interpretation - HİB; Data Collection - MMÖ, AG; Writing - MMÖ; Critical Revision - TÖ, MA; Final Approval - MKK; Overall Responsibility - MMÖ.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declare that this study has received no financial support.