Minimally Invasive Aortic Valve Replacement: Case Series Study.

Alen Karic, Harun Avdagic, Novica Kalinic, Ervin Busevac, Alma Krajnovic, Sekib Sokolovic
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Abstract

Background: Degenerative aortic stenosis is a prevalent and severe condition necessitating aortic valve replacement (AVR) when the valve area critically narrows to 0.7 cm² or when symptoms are manifested. Traditional AVR via median sternotomy, poses considerable risks for patients with comorbidities or advanced age.

Objective: This study evaluates the efficacy and safety of mini sternotomy aortic valve replacement (MSAVR), a minimally invasive technique designed to reduce surgical trauma, improve postoperative recovery, and lower healthcare costs.

Methods: A reversed L-type upper partial sternotomy (RLUPS) approach was performed in five patients focusing on standardized surgical procedures, and rigorous postoperative care. Key findings indicate that MSAVR markedly reduces postoperative complications, ICU stay, and overall hospital stay compared to traditional sternotomy.

Results: The median postoperative length of stay was seven days for MSAVR versus 12 days for traditional sternotomy, with ICU stays of 52 hours and 119 hours, respectively. Our study also highlights the cost-effectiveness of MSAVR, with decreased hospital costs per patient due to reduced ICU resource utilization and shorter hospital stays. These findings suggest that MSAVR is a valuable and advantageous alternative to traditional sternotomy, offering substantial benefits in terms of patient outcomes and healthcare efficiency.

Conclusion: Our work underscores the potential of minimally invasive techniques in improving the management of severe degenerative aortic stenosis, marking a significant advancement in the field of cardiac surgery.

微创主动脉瓣置换术:病例系列研究。
背景:退行性主动脉狭窄是一种常见且严重的疾病,当瓣膜面积严重狭窄至0.7 cm²或出现症状时,需要主动脉瓣置换术(AVR)。传统的经胸骨正中切开术的AVR,对于有合并症或高龄的患者有相当大的风险。目的:本研究评估小型胸骨切开主动脉瓣置换术(MSAVR)的有效性和安全性,MSAVR是一种微创技术,旨在减少手术创伤,改善术后恢复,降低医疗费用。方法:对5例患者行逆行l型上部分胸骨切开术(RLUPS),重点是标准化的手术程序和严格的术后护理。主要研究结果表明,与传统的胸骨切开术相比,MSAVR显著减少了术后并发症、ICU住院时间和总住院时间。结果:MSAVR组术后中位住院时间为7天,而传统胸骨切开术组为12天,ICU住院时间分别为52小时和119小时。我们的研究还强调了MSAVR的成本效益,由于ICU资源利用率降低和住院时间缩短,每位患者的住院费用降低。这些发现表明MSAVR是传统胸骨切开术的一种有价值和有利的替代方法,在患者预后和医疗效率方面提供了实质性的好处。结论:我们的工作强调了微创技术在改善严重退行性主动脉狭窄治疗方面的潜力,标志着心脏外科领域的重大进步。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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