Minimally invasive aortic root surgery: Midterm results in a 2-year follow-up.
Aged
Aortic Dissection
/ surgery
Aorta
/ surgery
Aortic Aneurysm
/ surgery
Blood Vessel Prosthesis Implantation
/ methods
Cardiopulmonary Bypass
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Minimally Invasive Surgical Procedures
/ methods
Operative Time
Postoperative Complications
/ epidemiology
Reoperation
/ statistics & numerical data
Safety
Sternotomy
/ methods
Surgical Wound Dehiscence
/ epidemiology
Time Factors
Treatment Outcome
Bentall operation
David operation
aortic root surgery
minimally invasive surgery
partial upper sternotomy
Journal
Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
pubmed:
24
5
2020
medline:
3
11
2020
entrez:
24
5
2020
Statut:
ppublish
Résumé
Minimally invasive surgery (MIS) via partial upper sternotomy (PUS) for aortic root surgery represents an alternative to the full median sternotomy (FMS). PUS offers less operative trauma. We analyzed the midterm outcome of root replacement (Bentall) or valve-sparing root replacement (David) via PUS to evaluate the safety of this access. Between November 2011 to April 2017, a total of 47 consecutive patients underwent aortic root surgery with aortic aneurysm and/or localized aortic dissection through Bentall or David operation through PUS mean age (57.9 ± 10.5 years). Bentall operation was performed in 36 patients (77%), whereas 11 patients (23%) received a David procedure. The outcome was carried out in 6-months, 1-year, and 2-years-follow up. Mean operation time was 287.3 ± 72.6 minutes, mean cardiopulmonary bypass (CPB) time 174 ± 54.8 minutes, mean cross-clamp time 133 ± 33.1 minutes. Rethoracotomy-rate was (4.2%). Superficial wound healing disturbance was (2%) and no deep sternal infection or sternum instability occurred. Hospitalization-and intensive care unit-stay was 11.8 ± 4.4 and 1.9 ± 1.3 days with a total median ventilation-time of 10 (IQR 7.5-13.5) hours. There was no 30-day-mortality. After 2 years the total rate of mortality, major adverse cardiac and cerebrovascular events, and redo surgery was (6.3%, 4.2%, and 4.2%). Minimally invasive aortic root surgery via partial upper sternotomy could be a safe alternative to the full median sternotomy. It requires longer operative times but reduces postoperative morbidity with good postoperative outcome.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1484-1491Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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