Minimally invasive aortic valve replacement through right minithoracotomy with completely central cannulation -- a single-center experience in 203 patients
التفاصيل البيبلوغرافية
العنوان:
Minimally invasive aortic valve replacement through right minithoracotomy with completely central cannulation -- a single-center experience in 203 patients
OBJECTIVES: Minimally invasive aortic valve replacement (mini-AVR) might improve clinical outcomes, particularly in high-risk and elderly patients. Sutureless/rapid deployment bioprosthesis can offer advantage of decreasing the cross-clamp time (XCT) and easing the procedure. Our aim was to evaluate the safety and perioperative outcomes of mini-AVR using sutureless bioprothesis via the right minithoracotomy approach with our modified technique of central cannulation. METHODS: We performed a single-center retrospective analysis of 203 patients consecutively undergoing isolated aortic valve replacement between March 2016 and June 2018 with the right minithoracotomy approach and our modified technique of central cannulation. Aortic valve diseases were stenosis (89.9%), regurgitation (1.6%) and mixed valve disease (8.5%). Patients with concomitant procedures were excluded. The primary endpoint was 30-day mortality. RESULTS: Mean age was 76±6.2 years, 63 (31%) patients were 80 years or older. Cardiopulmonary bypass (CPB) and XCT were 35 (24 – 76) and 60.5 (39 – 153) minutes, respectively. 30-day mortality was 1% (2 patients). We have observed minor paravalvular leak (PVL) which occurred in 7 patients (3.4%), and no moderate or severe PVL was found. There was no structural valve degeneration. Two (1%) patients needed conversion to full sternotomy, and two (1%) patients to ministernotomy. CONCLUSIONS: Mini-AVR via the right minithoracotomy approach with central cannulation is an effective and safe procedure and demonstrates excellent early clinical outcomes. This approach can be particularly valuable in higher risk and elderly patients.