Objectives: Due to recent spread of minimally
invasive surgery, the demand for minimally invasive cardiac surgery (MICS) is
increasing. We investigate the usefulness of minimally invasive aortic valve
replacement (MICS-AVR) which was performed in our hospital. Methods:Of 63 consecutive patients
undergone an isolated aortic valve replacement(AVR), 16 patients underwent MICS-AVR with partial lower
sternotomy (M group) and 47 patients underwent AVR with median full sternotomy
(C group).We
compared the two groups in a retrospective study. Results: No significant
difference was found in the surgical and perioperative-related factors between
the two groups. However, the average of aortic cross-clamping time was longer,
and intensive and high care unit stay was shorter in the M group. A tendency to
decrease blood transfusion was observed in the M group. There was no hospital
death in all patients. The mean follow-up period was 29 ± 15 months. There was
no significant difference between the two groups in the survival rate, and the
5-year
survival rates were 88.9% in the M group and 85.9% in the C group. Conclusion: It was suggested that the
MICS-AVR could be safe and useful procedure in AVR.
References
[1]
Cosgrove III, D.M. and Sabik, J.F. (1996) Minimally Invasive Approach for Aortic Valve Operations. The Annals of Thoracic Surgery, 62, 596-597.
https://doi.org/10.1016/0003-4975(96)00418-3
[2]
Lehmann, S., Merk, D.R., Etz, C.D., Seeburger, J., Schroeter, T., Oberbach, A., et al. (2015) Minimally Invasive Aortic Valve Replacement: The Leipzig Experience. Annals of Cardiothoracic Surgery, 4, 49-56.
[3]
Mihaljevic, T., Cohn, L.H., Unic, D., Aranki, S.F., Couper, G.S. and Byrne, J.G. (2004) One Thousand Minimally Invasive Valve Operations: Early and Late Results. Annals of Surgery, 240, 529-534.
https://doi.org/10.1097/01.sla.0000137141.55267.47
[4]
Bonacchi, M., Prifti, E., Giunti, G., Frati, G. and Sani, G. (2002) Does Ministernotomy Improve Postoperative Outcome in Aortic Valve Operation? A Prospective Randomized Study. The Annals of Thoracic Surgery, 73, 460-465.
https://doi.org/10.1016/S0003-4975(01)03402-6
[5]
Tabata, M., Umakanthan, R., Cohn, L.H., Bolman III, R.M., Shekar, P.S., Chen, F.Y., et al. (2008) Early and Late Outcomes of 1000 Minimally Invasive Aortic Valve Operations. European Journal of Cardio-Thoracic Surgery, 33, 537-541.
https://doi.org/10.1016/j.ejcts.2007.12.037
[6]
Doll, N., Borger, M.A., Hain, J., Bucerius, J., Walther, T., Gummert, J.F., et al. (2002) Minimal Access Aortic Valve Replacement: Effects on Morbidity and Resource Utilization. The Annals of Thoracic Surgery, 74, 1318-1822.
https://doi.org/10.1016/S0003-4975(02)03911-5
[7]
Christiansen, S., Stypmann, J., Tjan, T.D., Wichter, T., Van Aken, H., Scheld, H.H., et al. (1999) Minimally-Invasive versus Conventional Aortic Valve Replacement—Perioperative Course and Mid-Term Results. European Journal of Cardio-Thoracic Surgery, 16, 647-652. https://doi.org/10.1016/S1010-7940(99)00333-4
[8]
Detter, C., Deuse, T., Boehm, D.H., Reichenspumer, H. and Reichart, B. (2002) Midterm Results and Quality of Life after Minimally Invasive vs. Conventional Aortic Valve Replacement. Journal of Thoracic and Cardiovascular Surgery, 50, 337-341. https://doi.org/10.1055/s-2002-35743
[9]
Kocher, A.A., Laufer, G., Haverich, A., Shrestha, M., Walther, T., Misfeld, M., et al. (2013) One-Year Outcomes of the Surgical Treatment of Aortic Stenosis with a Next Generation Surgical Aortic Valve (TRITON) Trial: A Prospective Multicenter Study of Rapid-Deployment Aortic Valve Replacement with the EDWARDS INTUITY Valve System. Journal of Thoracic and Cardiovascular Surgery, 145, 110-115. https://doi.org/10.1016/j.jtcvs.2012.07.108
[10]
Folliguet, T.A., Laborde, F., Zannis, K., Ghorayeb, G., Haverich, A. and Shrestha, M. (2012) Sutureless Perceval Aortic Valve Replacement: Results of Two European Centers. The Annals of Thoracic Surgery, 93, 1483-1488.
https://doi.org/10.1016/j.athoracsur.2012.01.071
[11]
Glauber, M., Miceli, A., Gilmanov, D., Ferrarini, M., Bevilacqua, S., Farneti, P.A., et al. (2013) Right Anterior Minithoracotomy versus Conventional Aortic Valve Replacement: A Propensity Score Matched Study. Journal of Thoracic and Cardiovascular Surgery, 145, 1222-1226. https://doi.org/10.1016/j.jtcvs.2012.03.064
[12]
Murtuza, B., Pepper, J.R., Stanbridge, R.D., Jones, C., Rao, C., Darzi, A., et al. (2008) Minimal Access Aortic Valve Replacement: Is It Worth It? The Annals of Thoracic Surgery, 85, 1121-1131. https://doi.org/10.1016/j.athoracsur.2007.09.038
[13]
Merk, D.R., Lehmann, S., Holzhey, D.M., Dohmen, P., Candolfi, P., Misfeld, M., et al. (2015) Minimal Invasive Aortic Valve Replacement Surgery Is Associated with Improved Survival: A Propensity-Matched Comparison. European Journal of Cardio-Thoracic Surgery, 47, 11-17. https://doi.org/10.1093/ejcts/ezu068
