Minithoracotomy versus full sternotomy for isolated aortic valve replacement: Propensity matched data from two centers.
J Card Surg
; 36(1): 97-104, 2021 Jan.
Article
em En
| MEDLINE
| ID: mdl-33135258
ABSTRACT
BACKGROUND:
Minimally invasive approaches to isolated aortic valve replacement (AVR) continue to gain popularity. This study compares outcomes of AVR through right anterolateral thoracotomy (RALT) to those of AVR through full median sternotomy (MS).METHODS:
Outcomes of two propensity-matched groups of 85 each, out of 250 patients that underwent isolated AVR through RALT or MS at our two institutions, were compared in a retrospective study.RESULTS:
Propensity score matching resulted in 85 matched pairs with balanced preoperative characteristics. Procedure times were significantly shorter in the RALT group (median difference 13 min [-25 to -0.5]; p = .039), cardiopulmonary bypass times were longer (median difference 17 min [10-23.5]; p = < .001) and ventilation times shorter (median difference 259 min [-390 to -122.5]; p = < .001). There was no significant difference in aortic cross-clamp times (median difference 1.5 min [-3.5 to 6.5]; p = .573). The RALT group had lower rates of perioperative platelet transfusions (odds ratio [OR] = 0.00 [0.00-0.59]; p = .0078) and postoperative pneumonia (OR = 0.10 [0.00-0.70]; p = .012), as well as shorter hospitalization times (median difference 2.5 days [-4.5 to -1]; p = .005). There were no significant differences regarding paravalvular leakage (p = .25), postoperative stroke (p = 1), postoperative atrial fibrillation (p = .12) or 1-year-mortality (p = 1).CONCLUSIONS:
This study found RALT to be an equally safe approach to surgical AVR as MS. Furthermore, RALT showed advantages regarding important aspects of postoperative recovery, especially concerning pulmonary function.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Implante de Prótese de Valva Cardíaca
/
Esternotomia
Tipo de estudo:
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
J Card Surg
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha