Key result
Sternal-sparing approaches for combined aortic valve and coronary artery disease were feasible, with 0% 30-day mortality and a mean postoperative hospital stay of 3.1 days in 10 patients.
Why the study?
The study aimed to review outcomes of sternal-sparing approaches combining minimally invasive techniques in patients with concomitant aortic valve and coronary artery disease.
Observational (n=10)
No
Sternal-sparing approaches for combined aortic valve and coronary artery disease are feasible and associated with short hospital stays and no 30-day mortality in a small proof-of-concept series.
Sternal-sparing options feasible in small selected series; leaves open need for prospective trials before wider adoption.
OBJECTIVE: The standard management of concomitant aortic valve (AV) and coronary artery disease has been coronary artery bypass and AV replacement (AVR). With the advent of minimally invasive options, many isolated lesions have been successfully managed using a sternal-sparing approach. In our institution, patients with isolated AV disease are offered minimally invasive surgical or transcatheter AVR, and those with isolated coronary artery disease are routinely managed with robotic totally endoscopic coronary artery bypass or percutaneous coronary intervention. Various combinations of these techniques can be used when a sternal-sparing posture is desired because of patient risk or preference. The aim of this study was to review the outcomes in patients with combined AV and coronary disease who were managed using sternal-sparing approaches. METHODS: We reviewed the records of 10 patients in our minimally invasive surgical database who presented with concomitant AV and coronary artery disease and underwent combined sternal-sparing management of these 2 lesions using various combinations of minimally invasive approaches. RESULTS: Four patients had totally endoscopic coronary artery bypass and minimally invasive AVR at the same time, 2 patients underwent transcatheter AVR followed by totally endoscopic coronary artery bypass, and 4 patients underwent minimally invasive AVR with percutaneous coronary intervention. There was no 30-day mortality. The duration of postoperative surgical hospital stay was 3.1 ± 0.9 days. CONCLUSIONS: Sternal-sparing approaches in combined AV and coronary artery disease are feasible with patient-specific treatment selection of minimally invasive techniques.
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Watanabe et al. (2023) conducted an observational in Concomitant aortic valve and coronary artery disease (n=10). Sternal-sparing approaches was evaluated on 30-day mortality. Sternal-sparing approaches for combined aortic valve and coronary artery disease were feasible, with 0% 30-day mortality and a mean postoperative hospital stay of 3.1 days in 10 patients.
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