Key result
Minimally invasive aortic valve replacement via partial upper sternotomy resulted in 0% postoperative mortality, with no significant reduction in postoperative morbidity versus the conventional approach.
Why the study?
Does minimally invasive aortic valve replacement via partial upper sternotomy improve early postoperative outcomes compared to a conventional approach in patients undergoing AVR?
Cohort (n=100)
Does minimally invasive aortic valve replacement via partial upper sternotomy improve early postoperative outcomes compared to a conventional approach in patients undergoing AVR?
Answers are grounded in this paper and cite their sources.
Minimally invasive AVR via partial upper sternotomy is a safe and effective alternative to conventional sternotomy, though it did not significantly reduce early postoperative morbidity in this initial cohort.
BACKGROUND: Aortic valve replacement (AVR) can be performed through a partial upper sternotomy. In this study we compared the early postoperative outcome in two groups of patients who underwent AVR with a minimally invasive procedure (n = 30) or with a conventional approach (n = 70). The predicted operative mortality (Parsonnet Index) was slightly higher in the conventional group (17.69 +/- 0.85 versus 12.7 +/- 1.02), reflecting the greater mean age of the patients (70.96 +/- 1.17 versus 64.20 +/- 2.57). RESULTS: The distribution of the different etiologies of aortic valve pathology did not differ between groups. There was no postoperative death in the mini-invasive group. Cardiopulmonary bypass time was longer in the mini-invasive group, but the other operative parameters did not differ between groups. Postoperative morbidity regarding the need for blood transfusion, the duration of assisted ventilation, length of stay in the intensive care unit, and abnormalities of cardiac rhythm and conduction was slightly but not significantly reduced in the mini-invasive group. CONCLUSIONS: Our data demonstrate that a partial upper sternotomy is a safe and effective technique for AVR. Postoperative morbidity is not significantly reduced in patients undergoing AVR by this approach. Further studies in a larger patient population are necessary to assess whether postoperative morbidity is significantly reduced.
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Corbi et al. (2003) conducted a cohort in Aortic valve pathology (n=100). Minimally invasive aortic valve replacement (partial upper sternotomy) vs. Conventional approach was evaluated on Early postoperative outcome (mortality and morbidity). Minimally invasive aortic valve replacement via partial upper sternotomy resulted in 0% postoperative mortality, with no significant reduction in postoperative morbidity versus the conventional approach.
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