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. 2021 Dec 27;16(1):355.
doi: 10.1186/s13019-021-01739-w.

Converging rapid deployment prostheses with minimal access surgery: analysis of early outcomes

M Yousuf Salmasi  1   2 , Kristo Papa  3 , David Mozalbat  3 , Muhammad Ashraf  3 , Alicja Zientara  3 , Ishaan Chauhan  3 , Nikoleta Karadatkou  3 , Thanos Athanasiou  4 , Isabelle Roussin  5 , Cesare Quarto  3 , George Asimakopoulos  3
Affiliations

Converging rapid deployment prostheses with minimal access surgery: analysis of early outcomes

M Yousuf Salmasi et al. J Cardiothorac Surg. .

Abstract

Background: Sutureless prostheses may have added benefit when combined with minimal access surgery, although this has not been fully assessed in the literature. This study aims to provide a comparative analysis of the Perceval valve comparing median sternotomy (MS) with mini-sternotomy (MIS).

Methods: A retrospective analysis of prospectively collected data was conducted for all isolated aortic valve replacement (AVR), using the Perceval valve, for severe aortic stenosis cases in the period 2014 to 2019. Patients undergoing concomitant valve or revascularisation surgery were excluded.

Results: A total of 78 patients were included: MS group 41; MIS group 37. Operatively, bypass times were comparable between MS and MIS groups (mean 89.3 vs 83.4, p = 0.307), as were aortic cross clamp times (58.4 vs 55.9, p = 0.434). There were no operative deaths or new onset post-operative neurology. MIS was a predictor of reduced stay in the intensive care unit (coef - 3.25, 95% CI [- 4.93, - 0.59], p = 0.036) and hospital stay overall (p = 0.004). Blood transfusion units were comparable as were the incidence of heart block (n = 5 vs n = 3, p = 0.429) and new onset atrial fibrillation (n = 15 vs n = 9, p = 0.250). Follow-up echocardiography found a significant improvement in effective orifice area, left ventricular dimension and volume indices, and LVEF (p > 0.05) for all patients. Multivariate analysis found mini-sternotomy to be a predictor for reduced LV diastolic volume (coef - 0.35, 95% CI [- 1.02, - 0.05], p = 0.05).

Conclusions: The combination of minimal access surgery and sutureless AVR may enhance patient recovery and provide early LV remodelling.

Keywords: Aortic valve replacement; Mini-sternotomy; Perceval; Surtureless.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Brown ML, McKellar SH, Sundt TM, Schaff HV. Ministernotomy versus conventional sternotomy for aortic valve replacement: a systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2009;137:670–679. doi: 10.1016/j.jtcvs.2008.08.010. - DOI - PubMed
    1. Dalén M, Biancari F, Rubino AS, Santarpino G, De Praetere H, Kasama K, et al. Ministernotomy versus full sternotomy aortic valve replacement with a sutureless bioprosthesis: a multicenter study. Ann Thorac Surg. 2015;99:524–530. doi: 10.1016/j.athoracsur.2014.08.028. - DOI - PubMed
    1. Dalén M, Biancari F, Rubino AS, Santarpino G, Glaser N, De Praetere H, et al. Aortic valve replacement through full sternotomy with a stented bioprosthesis versus minimally invasive sternotomy with a sutureless bioprosthesis. Eur J Cardio-Thorac Surg. 2016;49:220–227. doi: 10.1093/ejcts/ezv014. - DOI - PubMed
    1. Brown JM, O’Brien SM, Wu C, Sikora JAH, Griffith BP, Gammie JS. Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database. J Thorac Cardiovasc Surg. 2009;137:82–90. doi: 10.1016/j.jtcvs.2008.08.015. - DOI - PubMed
    1. Bonacchi M, Prifti E, Giunti G, Frati G, Sani G. Does ministernotomy improve postoperative outcome in aortic valve operation? A prospective randomized study. Ann Thorac Surg. 2002;73:460–465. doi: 10.1016/S0003-4975(01)03402-6. - DOI - PubMed

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