Midterm Outcomes of Minimally Invasive Aortic Valve Replacement via Right Lateral Minithoracotomy.

IF 1.6 Q2 SURGERY
Akira Furutachi, Yoshitsugu Nakamura, Kusumi Niitsuma, Masaki Ushijima, Yuto Yasumoto, Daiki Yoshiyama, Miho Kuroda, Kosuke Nakamae, Yujiro Hayashi, Taisuke Nakayama, Ryo Tsuruta, Yujiro Ito
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引用次数: 0

Abstract

Objective: Minimally invasive aortic valve replacement (MIAVR) procedures have been found to have good short-term results. However, no known reports regarding outcomes of MIAVR via a right lateral minithoracotomy (LT) approach over longer terms have been presented. The aim of the present study was to analyze the midterm outcomes of the use of MIAVR with the right LT approach over an 8-year period.

Methods: Between September 2014 and February 2023, MIAVR was performed for 348 patients with severe aortic valve stenosis and regurgitation at our hospital. Operative mortality, all-cause mortality, and valve-related events were retrospectively examined.

Results: The mean patient age was 72.3 ± 10.9 years, while 78 patients (22.4%) were more than 80 years old. Surgical, cardiopulmonary bypass, and cross-clamp times were 194.7 ± 43.2, 118.6 ± 28.7, and 89.4 ± 23.3 min, respectively. The 30-day mortality rate was 0.3%. The mean follow-up period was 35.6 ± 25.9 months. Overall survival shown by Kaplan-Meier analysis at 1, 3, and 5 years was 96.4%, 90.3%, and 83.2%, respectively, and freedom from valve-related events at those time points was noted in 100%, 99.5%, and 96.9% of the cases, respectively.

Conclusions: MIAVR via a right LT approach was found to be associated with excellent short-term and midterm outcomes and is considered to have the potential to become an established surgical option.

经右侧小开胸微创主动脉瓣置换术的中期结果。
目的:微创主动脉瓣置换术(MIAVR)具有良好的短期效果。然而,没有关于经右外侧小开胸(LT)入路MIAVR长期预后的已知报告。本研究的目的是分析在8年期间使用MIAVR与正确的LT入路的中期结果。方法:2014年9月至2023年2月,对我院348例重度主动脉瓣狭窄并返流患者行MIAVR。回顾性分析手术死亡率、全因死亡率和瓣膜相关事件。结果:患者平均年龄为72.3±10.9岁,80岁以上患者78例(22.4%)。手术时间194.7±43.2 min,体外循环时间118.6±28.7 min,交叉钳夹时间89.4±23.3 min。30天死亡率为0.3%。平均随访时间为35.6±25.9个月。Kaplan-Meier分析显示,1年、3年和5年的总生存率分别为96.4%、90.3%和83.2%,在这些时间点无瓣膜相关事件的病例分别为100%、99.5%和96.9%。结论:经右左室入路的MIAVR具有良好的短期和中期预后,被认为有潜力成为一种成熟的手术选择。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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