ObjectiveTo compare the effect of thoracoscopic surgery and median sternotomy for mitral valvuloplasty in the treatment of mitral regurgitation. MethodsRetrospective analysis was made on the clinical data of 65 patients with mitral regurgitation who underwent mitral valvuloplasty. And the patients were divided into thoracoscope group (n=30) and median sternotomy group (n=35), according to the operation methods. The operation conditions, perioperative cardiopulmonary function indexes, hospitalization expenses, as well as 2-year postoperative complications, survival, and cardiac function changes were compared between the two groups. Results(1) The operation time, extracorporeal circulation time and aortic cross-clamping time in the thoracoscope group were longer than those in the median sternotomy group, while the chest closure time, the transfusion volume of red blood cells, fresh frozen plasma, human serum albumin, and the total transfusion volume of blood products were shorter or less in the thoracoscope group than in the median sternotomy group (all P＜0.05). However, there was no significant difference between the two groups in terms of the open assistance time, secondary blocking rate, secondary thoracotomy hemostasis rate, mechanical ventilation time, ICU stay, or total hospital stay (all P＞0.05). (2) Two weeks after operation, there was no significant difference in the left ventricular ejection fraction (LVEF), left atrial diameter (LAD), left ventricular end-diastolic diameter (LVED) and forced expiratory volume in one second (FEV1) between the two groups (all P＞0.05). However, LAD, LVED and FEV1 of the two groups were all lower than those before operation (all P＜0.05), and the LVEF of the two groups had no significant difference with that before operation (P＞0.05). Compared with the preoperative indexes, the forced vital capacity (FVC) decreased in both groups and was lower in the median sternotomy group than in the thoracoscope group (all P＜0.05). No moderate or severe mitral regurgitation was found in both groups after operation, and there was no significant difference between the two groups in terms of the mitral regurgitation (P＞0.05). (3) The mortality rate, respiratory infection rate, poor wound healing rate, arrhythmia rate, hospitalization expenses, and cardiac function grades at 1 and 2 years after operation between the two groups showed no significant difference (all P＞0.05). ConclusionThe efficacy and safety of thoracoscopic surgery in patients with mitral regurgitation is equivalent to that of median sternotomy for mitral valvuloplasty, which can shorten the chest closure time, reduce the consumption of blood products, release the financial burden of patients, without increasing the incidence of postoperative complications. It has good social benefits and is worthy of popularization and application.

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