Minimally invasive versus conventional aortic valve replacement: a prospective randomized trial.
J Heart Valve Dis
; 12(1): 76-80, 2003 Jan.
Article
em En
| MEDLINE
| ID: mdl-12578340
ABSTRACT
BACKGROUND AND AIM OF THE STUDY A prospective randomized study was performed to compare conventional with minimally invasive aortic valve replacement (AVR). METHODS:
Forty consecutive patients scheduled for elective aortic valve surgery were prospectively randomized either to the conventional group (group A, complete median sternotomy) or minimally invasive group (group B, partial upper sternotomy). Intraoperative and postoperative clinical data, and markers of myocardial and cerebral protection were determined. Neuropsychological tests were carried out to quantify psychological disorders.RESULTS:
Operative time and cardiopulmonary bypass time were slightly longer in group B, but not significantly so. No significant inter-group differences were found for postoperative pain scores and respiratory function. Chest tube drainage was significantly less in group B (495 +/- 165 versus 240 +/- 69 ml, p = 0.008). Creatine kinase (CK), CK-MB and troponin T levels were similar in both groups. Neither S-100B protein nor neuron-specific enolase levels differed significantly between groups at all sampling times. There were no strokes in the entire cohort. None of the neuropsychological tests yielded significant inter-group differences between conventional and minimally invasive surgery.CONCLUSION:
The safety and reliability of AVR via a partial upper sternotomy is reported. Minimally invasive AVR can be performed with only slightly longer operative times, good cosmetic results and significantly less blood loss. A limited surgical access affected neither the patients' neurological outcome nor the efficacy of myocardial protection.
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Bases de dados:
MEDLINE
Assunto principal:
Insuficiência da Valva Aórtica
/
Estenose da Valva Aórtica
/
Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Heart Valve Dis
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Alemanha