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156 Patient Reported Outcomes Measures Following Mitral Valve Repair: Minimally Invasive Video-Assisted Compared to Sternotomy
  1. Jennifer Whiteley1,
  2. Sion Jones2,
  3. Klare Exarchou1,
  4. Ken Palmer2,
  5. Paul Modi1
  1. 1Liverpool Heart and Chest Hospital
  2. 2LHCH

Abstract

Objectives There is a paucity of evidence regarding patient reported outcomes following mitral valve repair (MVP). Our aim was to compare these in patients having minimally invasive (MI) andsternotomy (St) approaches.

Method Between August 2011 and June 2014, 235 patients underwent MVP, of which 71 (30.2%) had a MI procedure performed through a 5–6 cm right anterior minithoracotomy. We adapted the Composite Physical Function questionnaire to retrospectively assess post-operative quality of life in 3 domains (scores were converted into a 0–100 scale) -– Recovery Time (higher score indicated longer recovery time); Pain (higher score indicated increased pain) and Treatment Satisfaction (higher score indicated improved satisfaction). The scores were risk-adjusted using pre-operative characteristics (age, gender, urgency, Logistic EuroSCORE). Data are reported as median (interquartile range).

Results The response rate was 70.6% (n = 166) of which 51(30.7%) underwent MI repair. Comparing St to MI, 14.8% vs 35.3% resumed ‘normal activities’ within 6 weeks of their operation (p = 0.003). The risk-adjusted Recovery Time domain results for St vs MI were 54.4 (44.4,69.6) vs. 44.9 (26.7, 58.0), p < 0.001; likewise, the risk-adjusted Pain domain results were 31.8 (16.9, 50.0) vs. 21.9 (12.4, 32.8), p = 0.03; and the risk-adjusted Treatment Satisfaction domain results were 98.1 (83.9, 99.9) vs. 98.3 (88.9, 100.0), p = 0.25. Comparing St to MI, 53.0% vs. 78.4% reported that they were ‘Very Satisfied’ with the appearance of their scar (p = 0.002).

Conclusion Minimally invasive mitral valve repair speeds recovery, reduces pain and improves cosmesis compared to a sternotomy approach. Both approaches score highly on patient satisfaction.

  • mitral
  • minimally invasive
  • quality of life

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