[Clinical study of minimally invasive versus conventional sternotomy for aortic valve replacement]

Abstract

Objective: To compare the perioperative outcomes of minimally invasive versus conventional aortic valve replacement.

Methods: Between June 2010 and January 2012, 39 patients underwent isolated aortic valve replacement (minimally invasive: n=24, conventional: n=15) at our department. Gender, age, New York Heart Association class, valvular size, valvular type, cardiopulmonary bypass duration, aortic cross-clamping duration, total operative duration (skin incision to skin suture), ventilation time, intensive care unit stay, blood loss volume, blood transfusion volume, left ventricle ejection fraction, perioperative complications, length of incision, hospital stay and hospital costs were used.

Results: There was no case of death or reoperation for bleeding. No statistically significant differences existed between both groups with respect to perioperative course (both P>0.05). Only cardiopulmonary bypass duration and aortic cross-clamping duration were significantly longer in the minimally invasive group while blood transfusion rate (9/24 vs 12/15, P=0.028) and length of incision ((4.9±0.7) cm vs (28.5±4.7) cm, P=0.000) were significantly lower in the minimally invasive group.

Conclusion: As a safe and reproducible procedure, minimally invasive aortic operation may require a smaller incision and achieve better cosmetic outcomes with a lesser volume of blood transfusion.