Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 25:11:1369204.
doi: 10.3389/fcvm.2024.1369204. eCollection 2024.

Right anterior thoracotomy vs. upper hemisternotomy for aortic valve replacement with Perceval S: is there a difference?

Bogdan Okiljevic  1 , Tatjana Raickovic  1 , Igor Zivkovic  1   2 , Petar Vukovic  1   2 , Miroslav Milicic  1   2 , Ivan Stojanovic  1   2 , Petar Milacic  1   2 , Slobodan Micovic  1   2
Affiliations

Right anterior thoracotomy vs. upper hemisternotomy for aortic valve replacement with Perceval S: is there a difference?

Bogdan Okiljevic et al. Front Cardiovasc Med. .

Abstract

Background: Our study aimed to evaluate the early outcomes of aortic valve replacement with Perceval S sutureless valve through the right anterior thoracotomy and upper hemisternotomy approaches, and to determine if there are any differences between these two approaches.

Methods: We carried out a study using data from 174 patients who underwent minimally invasive Perceval S valve implantation for aortic valve stenosis between January 2018 and August 2023. This was a retrospective, single-center observational study. The patients were divided into two groups: the hemisternotomy group (n = 100) and the right anterior thoracotomy group (n = 74).

Results: The overall in-hospital mortality was 1,7%. The cardiopulmonary bypass and cross-clamp times were longer in the right anterior thoracotomy group (p < .001). There were no statistically significant differences in terms of stroke, paravalvular leak, mechanical ventilation time, blood transfusion requirements, pacemaker implantation, reexploration for bleeding, conversion, wound infection, or in-hospital stay. Postoperative chest drainage was lower (p < .001) and postoperative atrial fibrillation occurred less frequently (p = .044) in the right anterior thoracotomy group. The median intensive care unit stay was shorter in the right anterior thoracotomy group (p = .018).

Conclusion: Aortic valve replacement with the Perceval S valve through either an upper hemisternotomy or a right anterior thoracotomy is a procedure associated with low perioperative complication rates. Right anterior thoracotomy for an aortic valve replacement with the Perceval S valve was associated with lower postoperative bleeding, a lower postoperative atrial fibrillation incidence and a shorter intensive care unit stay compared to upper hemistornotomy.

Keywords: aortic valve replacement; hemisternotomy; minimally invasive; sutureless valve; thoracotomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. (2022) 43(7):561–632. 10.1093/eurheartj/ehab395 - DOI - PubMed
    1. Rosengart TK, Feldman T, Borger MA, Vassiliades TA, Jr, Gilinov AM, Hoercher KJ, et al. Percutaneous and minimally invasive valve procedures: a scientific statement from the American Heart Association council on cardiovascular surgery and anesthesia, council on clinical cardiology, functional genomics and translational biology interdisciplinary working group, and quality of care and outcomes research interdisciplinary working group. Circulation. (2008) 117:1750–67. 10.1161/CIRCULATIONAHA.107.188525 - DOI - PubMed
    1. Glauber M, Miceli A, Gilmanov D, Ferrarini M, Bevilacqua S, Farneti PA, et al. Right anterior minithoracotomy versus conventional aortic valve replacement: a propensity score matched study. J Thorac Cardiovasc Surg. (2013) 145(5):1222–26. 10.1016/j.jtcvs.2012.03.064 - DOI - PubMed
    1. Brinkman WT, Hoffman W, Dewey TM, Culica D, Prince SL, Herbert MA, et al. Aortic valve replacement surgery: comparison of outcomes in matched sternotomy and port access groups. Ann Thorac Surg. (2010) 90:131–5. 10.1016/j.athoracsur.2010.03.055 - DOI - PubMed
    1. Malaisrie SC, Barnhart GR, Farivar RS, Mehall J, Hummel B, Rodriguez E, et al. Current era minimally invasive aortic valve replacement: techniques and practice. J Thorac Cardiovasc Surg. (2014) 147(1):6–14. 10.1016/j.jtcvs.2013.08.086 - DOI - PubMed

LinkOut - more resources