Early Result of Minimally Invasive Aortic Valve Replacement (MIAVR) in Central Institute of Thailand
Keywords:
Minimally invasive, Aortic valve replacement (AVR), Early resultAbstract
Background: Aortic valve disease is a common valvular heart disease and its incidence is likely to increase with age. The conventional approach in the treatment of aortic valve disease is aortic valve replacement (AVR) through a full sternotomy. Minimally invasive aortic valve replacement (MIAVR) is defined as an AVR procedure that involves a small chest wall incision. The MIAVR is a safe procedure, less invasive approach, while maintaining the same efficacy and quality of a conventional approach.
Objectives: The main objectives of this study were clinical outcomes, postoperative complication and functional class are reviewed.
Method: A retrospective study of our database identified 23 patients who underwent MIAVR at Central Chest Institute of Thailand from January 2017 to January 2019.
Results: There were 15 men, with a mean age of 58 years. The patients presented with congestive heart failure (44%) and angina (39%). Most of the patients (69.6%) were in New York Heart Association (NYHA) class III. Left ventricular ejection fraction 62.5%± 9%. Mean cross clamp time was 83.3±13.6 minutes and mean cardiopulmonary bypass (CPB) time was 102.3± 14.8 minutes. There is no in-hospital mortality and neurological complication. One patient underwent reoperation due to aortic paravalvular leakage. The length of stay (LOS) in ICU was 1.2±0.2 days and LOS in hospital was 7 day. All of the patients were New York Heart Association class I after the operation.
Conclusion: Minimally invasive AVR can be performed safely and effectively with very few perioperative complications. The early outcome in these patients are excellent.
References
Malaisrie SC, Barnhart GR, Farivar RS, Mehall J, Hummel B, Rodriguez E, et al. Current era minimally invasive aortic valve replacement:techniques and practice. J Thorac Cardiovasc Surg 2014; 147:6-14.
Cosgrove DM, 3rd, Sabik JF. Minimally invasive approach for aortic valve operations. Ann Thorac Surg 1996; 62:596-7.
Svensson LG, D’Agostino RS. “J” incision minimal-access valve operations. Ann Thorac Surg 1998; 66:1110-2.
Glauber M, Miceli A, Bevilacqua S, Farneti PA. Minimally invasive aortic valve replacement via right anterior minithoracotomy: early outcomes and midterm follow-up. J Thorac Cardiovasc Surg 2011; 142:1577-9.
Merk DR, Lehmann S, Holzhey DM, Dohmen P, Candolfi P, Misfeld M, et al. Minimal invasive aortic valve replacement surgery is associated with improved survival: a propensity-matched comparison. Eur J Cardiothorac Surg 2015;47:11-7.
Shehada SE, Ozturk O, Wottke M, Lange R. Propensity score analysis of outcomes following minimal access versus conventional aortic valve replacement. Eur J Cardiothorac Surg 2016;49:464-9.
Glauber M, Miceli A, Gilmanov D, Ferrarini M, Bevilacqua S, Farneti PA, et al. Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study. J Thorac Cardiovasc Surg 2013;145:1222-6.
Johnston DR, Atik FA, Rajeswaran J, Blackstone EH, Nowicki ER, Sabik JF 3rd, et al. Outcomes of less invasive J-incision approach to aortic valve surgery. J Thorac Cardiovasc Surg 2012 ;144:852-8.
Lamelas J, Sarria A, Santana O, Pineda AM, Lamas GA.Outcomes of minimally invasive valve surgery versus median sternotomy in patients age 75 years or greater. Ann Thorac Surg 2011;91:79-84.
Sharony R, Grossi EA, Saunders PC, Schwartz CF, Ribakove GH, Baumann FG, et al. Propensity score analysis of a six-year experience with minimally invasive isolated aortic valve replacement. J Heart Valve Dis 2004;13:887-93.
Tabata M, Umakanthan R, Cohn LH, Bolman RM 3rd, Shekar PS, Chen FY, et al. Early and late outcomes of 1000 minimally invasive aortic valve operations. Eur J Cardiothorac Surg 2008;33:537-41.
Brinkman WT, Hoffman W, Dewey TM, Culica D, Prince SL, Herbert MA, et al. Aortic valve replacement surgery: comparison of outcomes in matched sternotomy and PORT ACCESS groups. Ann Thorac Surg 2010;90:131-5.
Hassan M, Miao Y, Maraey A, Lincoln J, Brown S, Windsor J, et al. Minimally Invasive Aortic Valve Replacement: CostBenefit Analysis of Ministernotomy Versus Minithoracotomy Approach. J Heart Valve Dis 2015;24:531-9.
Fattouch K, Moscarelli M, Del Giglio M, Albertini A, Comoglio C, Coppola R, et al. Non-sutureless minimally invasive aortic valve replacement: mini-sternotomy versus mini-thoracotomy: a series of 1130 patients. Interact CardioVasc Thorac Surg 2016; 23:253-8.
Semsroth S, Matteucci-Gothe R, Heinz A, Dal Capello T, Kilo J, Muller L, et al. Comparison of Anterolateral Minithoracotomy Versus Partial Upper Hemisternotomy in Aortic Valve Replacement. Ann Thorac Surg 2015; 100:868-73.
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