Minimally Invasive Approaches Versus Conventional Sternotomy for Aortic Valve Replacement: a Propensity Score Matching Study

Overview

Journal Korean J Thorac Cardiovasc Surg

Specialty Cardiology & Vascular Diseases

Date 2012 Apr 14

PMID 22500276

Citations 5

Authors

Ji Hyun Bang

Jong Wook Kim

Jae Won Lee

Joon Bum Kim

Sung-Ho Jung

Suk Jung Choo

Cheol Hyun Chung

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study is to evaluate our institutional results of the aortic valve replacement through minimally invasive approaches compared with conventional sternotomy.

Materials And Methods: From August 1997 to July 2010, 838 patients underwent primary isolated aortic valve replacement. Of them, 73 patients underwent surgery through minimally invasive approaches (MIAS group) whereas 765 patients underwent surgery through the conventional sternotomy (CONV group). Clinical outcomes were compared using a propensity score matching design.

Results: Propensity score matching yielded 73 pairs of patients in which there were no significant differences in baseline profiles between the two groups. Patients in the MIAS group had longer aortic cross clamp than those in the CONV group (74.9±27.9 vs.. 66.2±27.3, p=0.058). In the MIAS group, conversion to full sternotomy was needed in 2 patients (2.7%). There were no significant differences in the rates of low cardiac output syndrome (4 vs. 8, p=0.37), reoperation due to bleeding (7 vs. 6, p=0.77), wound infection (2 vs. 4, p=0.68), or requirements for dialysis (2 vs. 1, p=0.55) between the two groups. Postoperative pain was significantly less in the MIAS group than the conventional group (pain score, 3.79±1.67 vs. 4.32±1.56; p=0.04).

Conclusion: Both minimally invasive approaches and conventional sternotomy had comparable early clinical outcomes in patients undergoing primary isolated aortic valve replacement. Minimally invasive approaches significantly decrease postoperative pain.

Citing Articles

Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies.

Mohamed M, Ding S, Zulfiqar Ali Shah S, Li R, Dirie N, Cheng C Front Cardiovasc Med. 2021; 8:724178.

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Improved operative and recovery times with mini-thoracotomy aortic valve replacement.

Olds A, Saadat S, Azzolini A, Dombrovskiy V, Odroniec K, Lemaire A J Cardiothorac Surg. 2019; 14(1):91.

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Establishment of a minimally invasive cardiac surgery programme in Singapore.

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International Expert Consensus on Sutureless and Rapid Deployment Valves in Aortic Valve Replacement Using Minimally Invasive Approaches.

Glauber M, Moten S, Quaini E, Solinas M, Folliguet T, Meuris B Innovations (Phila). 2016; 11(3):165-73.

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Ministernotomy or minithoracotomy for minimally invasive aortic valve replacement: a Bayesian network meta-analysis.

Phan K, Xie A, Tsai Y, Black D, Di Eusanio M, Yan T Ann Cardiothorac Surg. 2015; 4(1):3-14.

PMID: 25694971 PMC: 4311162. DOI: 10.3978/j.issn.2225-319X.2014.08.01.

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