To compare the clinical effects of mitral valve replacement and tricuspid annuloplasty under a total thoracoscope and with traditional median thoracic incision.

According to the inclusion and exclusion criteria, 60 patients who visited Haikou People′s Hospital (Affiliated to Xiangya Medical College of Zhongnan University) and the First Affiliated Hospital of Jinan University in Guangzhou from January 2017 to December 2018 were selected for this study. According to the patients′wishes, 31 cases underwent total thoracoscopic mitral valve replacement and tricuspid annuloplasty as the experimental group and 29 cases underwent mitral valve replacement and tricuspid annuloplasty with traditional median thoracic incision as the control group. The operation time, ascending aorta blocking time, cardiopulmonary bypass time, incision range, duration of postoperative mechanical ventilation, residence time in the intensive care unit, hospital stay time after operation, thoracic fluid drainage and drainage tube extraction time were recorded, and the occurrence of postoperative complications was observed.

The operation time, cardiopulmonary bypass time, incision range and chest closure time in the experimental group were less than those of the control group (P<0.05), while the ascending aorta occlusion time had no statistical significance between the two groups (P>0.05). The duration of mechanical ventilation, the residence time in the intensive care unit, the hospital stay time, the drainage volume of pleural fluid and the time of drainage tube removal in the experimental group were all less than those of the control group (P<0.05). In the experimental group, pneumothorax was found in 1 case, pulmonary infection in 2 cases and arrhythmia in 1 case, with the total incidence of adverse reactions of 6.56%. While in the control group, pneumothorax was found in 2 cases, pulmonary infection in 4 cases and arrhythmia in 3 cases, with the total incidence of adverse reactions of 14.52% (P<0.05).

Compared with the traditional median thoracic incision, the mitral valve replacement and tricuspid annuloplasty under a total thoracoscope has shorter operation time, cardiopulmonary bypass time, chest closure time, mechanical breathing time after operation, residence time in the intensive care unit, hospitalization time after operation and drainage tube extraction time, smaller incision, fewer drainage materials after operation, and fewer complications. Therefore, it has more safety and higher practicability.