Minimally invasive aortic valve replacement: an alternative to the conventional technique

Rev Bras Cir Cardiovasc. 2012 Dec;27(4):570-82. doi: 10.5935/1678-9741.20120099.
[Article in English, Portuguese]

Abstract

Objectives: To demonstrate the use of minimally invasive surgery for aortic valve replacement and compare your results with the traditional method.

Methods: Between 2006 and 2011 sixty patients underwent surgery on aortic valve, after written consent, these 40 by minimally invasive technique with right anterior minithoracotomy access (Group 1/G1) and 20 by median sternotomy (Group 2/G2). Compare the operating times and postoperative evolution intra-hospital.

Results: The average times of bypass and aortic crossclamp in G1 were, respectively, 142.7 ± 59.5 min and 88.6 ± 31.5 min and, in G2, 98.1 ± 39.1 min and 67.7 ± 26.2 min (P < 0.05), a difference in medians of 39 minutes in bypass time and 23 minutes in aortic cross-clamp were observed in favour of conventional technique. The blood loss by the thoracic drains was significantly lower in the Group: minimally invasive 605.1 ± 679.5 ml (G1) versus 1617 ± 1390 ml (G2) (P < 0.05).The average time of ICU and hospital stay were shorter in G1: 2.3 ± 1.8 and 5.5 ± 5.4 days versus 5.1 ± 3.6 and 10 ± 5.1 in G2 (P < 0.05), respectively. Vasoactive drug use was also less post-operative at 12.8% in minimally invasive group G1 versus 45% in G2.

Conclusion: Aortic valve replacement through minimally invasive techniques, although intraoperative times larger, not demonstrate affect postoperative results that this case proved best when compared to the traditional approach.

Publication types

  • Comparative Study

MeSH terms

  • Aortic Valve Stenosis / surgery*
  • Blood Loss, Surgical / statistics & numerical data
  • Blood Volume
  • Female
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Postoperative Period
  • Sternotomy / methods*
  • Thoracotomy / methods*
  • Time Factors
  • Treatment Outcome