Premium
Minimally invasive aortic valve replacement with sutureless bioprosthesis through right minithoracotomy with completely central cannulation—Early results in 203 patients
Author(s) -
Sef Davorin,
Krajnc Martina,
Klokocovnik Tomislav
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15257
Subject(s) - medicine , aortic valve replacement , surgery , perioperative , concomitant , cardiopulmonary bypass , stenosis , thoracotomy , single center , regurgitation (circulation) , cardiology
Objectives Minimally invasive aortic valve replacement (mini‐AVR) might improve clinical outcomes, particularly in high‐risk and elderly patients. Sutureless/rapid deployment bioprosthesis can offer advantage of decreasing the cross‐clamp time (XCT) and easing the procedure. Our aim was to evaluate the safety and perioperative outcomes of mini‐AVR using sutureless bioprothesis via the right minithoracotomy approach with our modified technique of central cannulation. Methods We performed a single‐center retrospective analysis of 203 patients consecutively undergoing isolated AVR between March 2016 and June 2018 with the right minithoracotomy approach and our modified technique of central cannulation. Aortic valve diseases were stenosis (89.9%), regurgitation (1.6%), and mixed valve disease (8.5%). Patients with concomitant procedures were excluded. Primary endpoints were 30‐day and 4‐month mortality. Results Mean age was 76 ± 6.2 years, 63 (31%) patients were 80 years or older. Cardiopulmonary bypass and XCT were 60.5 (39–153) and 35 (24–76) min, respectively. Thirty‐day and 4‐month mortality were 1% (two patients). We have observed minor paravalvular leak (PVL) which occurred in seven patients (3.4%), and no moderate/severe PVL was found perioperatively. One patient developed moderate/severe PVL during the 4‐month follow‐up. There was no structural valve degeneration. Two (1%) patients needed conversion to full sternotomy, and two (1%) patients to ministernotomy. Conclusions Mini‐AVR via the right minithoracotomy approach with central cannulation is an effective and safe procedure and demonstrates excellent early clinical outcomes. This approach can be particularly valuable in higher risk and elderly patients.