8 weeks ahead of sternotomy patients [8] The most insightful evi

8 weeks ahead of sternotomy patients [8]. The most insightful evidence comes from 2 studies reporting that patients Crizotinib buy undergoing surgery via a minimally invasive approach as their second procedure all thought that their recovery was faster/less painful than their original sternotomy [30, 79]. 10. Elderly Patients Iribarne et al. demonstrated that MIMVS can be performed safely in patients at ��75 years old [80]. Although the minimally invasive approach was associated with slightly longer CPB and cross clamp times than was the conventional sternotomy approach, there were no significant differences in postoperative morbidity and mortality. Importantly, patients undergoing MIMVS had approximate 3 days shorter mean and 1 day shorter median durations of hospitalization, a finding that has important implications for resource use.

There were significant reductions in both mean and median costs of hospitalization associated with the minimally invasive approach, a finding that correlates with the observed difference in duration of hospitalization found between the groups. In addition, patients undergoing MIMVS had faster rates for both time to independent ambulation and time to independent sit-to-stand activity [80]. Grossi et al. analyzed 111 patients undergoing MIMVS who were at least 70 years old and compared these to 259 patients having a sternotomy and concluded that this approach can be used safely in operations on the elderly population with excellent result [34]. Felger et al. recently reported 123 cases of minimal invasive mitral valve repair in patients aged ��70 years with 1.

6% operative mortality as well as 5-year actuarial survival of 87% and 5-year freedom from reoperation of 93% [30, 79]. To date, no studies have assessed any difference in postoperative functional status by type of surgery. 11. Hospital Stay and Costs Some of the reported benefits of MIMVS include decreased intensive care unit a and total hospital length of stay, faster physical rehabilitation, and decreased overall hospital resource use [35, 40, 81, 82]. MIMVS is a cost-effective and cost-saving strategy for mitral valve repair and replacement compared with the traditional approach with lower cost driven largely by a decreased length of stay [80]. 12. Conclusions MIMVS has been proven to be a feasible alternative to the conventional full sternotomy approach with low perioperative morbidity and short-term mortality. Reported benefits of MIMVS include decreased postoperative pain, improved postoperative respiratory function, reduced surgical trauma, and greater patient satisfaction. Finally, Carfilzomib compared to standard surgery, MIMVS demonstrated comparable efficacy across a range of long-term efficacy measures such as freedom from reoperation and long-term survival.

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