Key result
Minimal access AVR matches sternotomy mortality but is associated with more revisions and late effusions.
Why the study?
The advantages and risks of minimal access aortic valve replacement compared to the standard sternotomy procedure were not well defined.
Does minimal access aortic valve replacement improve postoperative outcomes compared to standard sternotomy in adult patients undergoing isolated aortic valve replacement?
Cohort (n=271)
Does minimal access aortic valve replacement improve postoperative outcomes compared to standard sternotomy in adult patients undergoing isolated aortic valve replacement?
Absolute Event Rate: 2.8% vs 4.1%
Minimal access aortic valve replacement is safe but associated with a higher risk of incision-related morbidity, including revision and late pericardial effusion, compared to standard sternotomy.
Minimal access aortic valve replacement was associated with higher revision and effusion rates without mortality difference; leaves open net benefit pending randomized data.
BACKGROUND: to determine the advantages and/or risks of minimal access aortic valve replacement compared to standard sternotomy procedure. METHODS: from January 1997 to December 2001, 271 consecutive adult patients underwent isolated aortic valve replacement of which 174 underwent a minimal access procedure (Group 1) and 97 a standard procedure (Group 2). The preoperative variables of both groups were comparable. Retrospective analysis of postoperative outcome was performed. RESULTS: follow-up was complete and ranged from 6 months to 4 years. Overall in-hospital mortality was 3.3% (respectively 2.8 and 4.1%). No statistical difference was noted regarding operative time variables, mortality rate and hospital stay. There was a significant higher incidence of revision (p = 0.018) and late pericardial effusion (p = 0.022) in the minimal access group. Also trends were in favour of the standard group for incidence of postoperative pneumothorax and pericarditis constrictiva. CONCLUSIONS: minimal access aortic valve replacement is a safe and reliable technique, but carries the risk of incision-related morbidity. Proper patient selection and perioperative management is mandatory.
No takes yet. Share an insight, caveat, or question.
Vanoverbeke et al. (2004) conducted a cohort in Isolated aortic valve replacement (n=271). Minimal access aortic valve replacement vs. Standard sternotomy procedure was evaluated on In-hospital mortality. Minimal access aortic valve replacement had similar in-hospital mortality to standard sternotomy (2.8% vs 4.1%) but higher incidence of revision (P=0.018) and late pericardial effusion (P=0.022).
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: