TY - JOUR
T1 - Mini-aortic surgery with percutaneous cannulation and rapid-deployment valve
AU - Bruno, Piergiorgio
AU - Farina, Piero
AU - Cammertoni, Federico
AU - Biondi, Raoul
AU - Perri, Gianluigi
AU - Di Cesare, Alessandro
AU - Crea, Filippo
AU - Massetti, Massimo
PY - 2016
Y1 - 2016
N2 - BACKGROUND:
We aimed to evaluate the results of the combined use of rapid-deployment valves, percutaneous cardioplegia delivery and left heart venting during minimally invasive aortic valve replacement surgery.
METHODS:
We identified 2 propensity-matched cohorts of patients who underwent primary elective isolated minimally invasive aortic valve surgery at our center over a 3-years period: 30 patients in group A had a conventional valve prosthesis and 30 patients in group B received a rapid-deployment valve using percutaneous cardioplegia delivery and percutaneous left heart venting. Skin incision length, intraoperative times, postoperative hospital outcomes, and 30-day echocardiographic results were compared between the 2 groups.
RESULTS:
Patients in group B had significantly shorter operative times and shorter skin incisions compared to group A (total operative time 196.0 ± 40.6 vs. 225.1 ± 30.8 min, respectively, p < 0.003; cardiopulmonary bypass time 79.9 ± 10.6 vs. 92.9 ± 17.2 min respectively, p < 0.001; crossclamp time 52.3 ± 9.6 vs. 74.9 ± 10.2 min, respectively, p < 0.001; incision length 3.6 ± 0.5 vs. 6.0 ± 0.6 cm, respectively, p < 0.001). Postoperative hospital outcomes and echocardiographic evaluation showed no significant differences.
CONCLUSIONS:
The combined use of rapid-deployment valves, percutaneous cardioplegia, and left heart venting is safe and effective and allows a significant reduction of the skin incision together with a significant reduction of intraoperative times without affecting hospital outcomes or hemodynamic performance of the prosthetic valves
AB - BACKGROUND:
We aimed to evaluate the results of the combined use of rapid-deployment valves, percutaneous cardioplegia delivery and left heart venting during minimally invasive aortic valve replacement surgery.
METHODS:
We identified 2 propensity-matched cohorts of patients who underwent primary elective isolated minimally invasive aortic valve surgery at our center over a 3-years period: 30 patients in group A had a conventional valve prosthesis and 30 patients in group B received a rapid-deployment valve using percutaneous cardioplegia delivery and percutaneous left heart venting. Skin incision length, intraoperative times, postoperative hospital outcomes, and 30-day echocardiographic results were compared between the 2 groups.
RESULTS:
Patients in group B had significantly shorter operative times and shorter skin incisions compared to group A (total operative time 196.0 ± 40.6 vs. 225.1 ± 30.8 min, respectively, p < 0.003; cardiopulmonary bypass time 79.9 ± 10.6 vs. 92.9 ± 17.2 min respectively, p < 0.001; crossclamp time 52.3 ± 9.6 vs. 74.9 ± 10.2 min, respectively, p < 0.001; incision length 3.6 ± 0.5 vs. 6.0 ± 0.6 cm, respectively, p < 0.001). Postoperative hospital outcomes and echocardiographic evaluation showed no significant differences.
CONCLUSIONS:
The combined use of rapid-deployment valves, percutaneous cardioplegia, and left heart venting is safe and effective and allows a significant reduction of the skin incision together with a significant reduction of intraoperative times without affecting hospital outcomes or hemodynamic performance of the prosthetic valves
KW - Aortic valve
KW - Cardiac surgical procedures
KW - Heart valve prosthesis implantation
KW - Minimally invasive surgical procedures
KW - Sternotomy
KW - Aortic valve
KW - Cardiac surgical procedures
KW - Heart valve prosthesis implantation
KW - Minimally invasive surgical procedures
KW - Sternotomy
UR - http://hdl.handle.net/10807/88013
U2 - 10.1177/0218492316654774
DO - 10.1177/0218492316654774
M3 - Article
SN - 0218-4923
VL - 24
SP - 535
EP - 540
JO - Asian Cardiovascular and Thoracic Annals
JF - Asian Cardiovascular and Thoracic Annals
ER -