Minimally invasive aortic valve replacement: an alternative to the conventional technique

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 27; no. 4; p. 570
• Main Authors: Fortunato Júnior, Jeronimo Antonio, Fernandes, Alexandre Gabelha, Sesca, Jeferson Roberto, Paludo, Rogério, Paz, Maria Evangelista, Paludo, Luciana, Pereira, Marcelo Luiz, Araujo, Amélia
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01-01-2012
• Subjects: Aortic Valve Stenosis - surgery; Blood Loss, Surgical - statistics & numerical data; Blood Volume; Calcification; Coronary vessels; Extubation; Female; Heart surgery; Heart Valve Prosthesis Implantation - methods; Hospital costs; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; Ostomy; Pericardium; Postoperative Period; Sternotomy - methods; Thoracotomy - methods; Time Factors; Treatment Outcome; Veins & arteries; United States > US
• ISSN: 0102-7638; 1678-9741
• DOI: 10.5935/1678-9741.20120099

To demonstrate the use of minimally invasive surgery for aortic valve replacement and compare your results with the traditional method.
Between 2006 and 2011 sixty patients underwent surgery on aortic valve, after written consent, these 40 by minimally invasive technique with right anterior minithoracotomy access (Group 1/G1) and 20 by median sternotomy (Group 2/G2). Compare the operating times and postoperative evolution intra-hospital.
The average times of bypass and aortic crossclamp in G1 were, respectively, 142.7 ± 59.5 min and 88.6 ± 31.5 min and, in G2, 98.1 ± 39.1 min and 67.7 ± 26.2 min (P < 0.05), a difference in medians of 39 minutes in bypass time and 23 minutes in aortic cross-clamp were observed in favour of conventional technique. The blood loss by the thoracic drains was significantly lower in the Group: minimally invasive 605.1 ± 679.5 ml (G1) versus 1617 ± 1390 ml (G2) (P < 0.05).The average time of ICU and hospital stay were shorter in G1: 2.3 ± 1.8 and 5.5 ± 5.4 days versus 5.1 ± 3.6 and 10 ± 5.1 in G2 (P < 0.05), respectively. Vasoactive drug use was also less post-operative at 12.8% in minimally invasive group G1 versus 45% in G2.
Aortic valve replacement through minimally invasive techniques, although intraoperative times larger, not demonstrate affect postoperative results that this case proved best when compared to the traditional approach.