Minimally Invasive versus Conventional Aortic Valve Replacement Surgery: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHENGWei , CHIYi-fan , HOUWen-ming , SUNLong , NIUZhao-zhuo , LinMing-shan ,  YINHong

Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Medical College of Qingdao University, Qingdao 266071 Shandong, P. R. China;

Corresponding author：

YINHong, Email: yinhong1994@163.com

Keywords：

Upper median sternotomy; Aortic valve replacement; Minimally invasive

DOI：

10.7507/1007-4848.20150170

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the clinical experience of aortic valve replacement surgery with minimally invasive procedure. Methods We retrospectively analyzed the clinical data of 72 patients underwent isolated aortic valve replacement in our hospital between January 2011 and August 2013. The patients undergoing minimally invasive procedure were as a minimally invasive group(30 patients with 18 males and 12 females at age of 60.2±13.4 years). The patients undergoings conventional procedure were as a control group(42 patients with 27 males and 15 females at age of 61.3±14.5 years). The outcomes of the two groups were compared. Results There was no death and severe complication in both groups. Postoperative echocardiography showed no paravalvular leakage, no valve dysfunction in both groups. There were no significant statistically differences between the two groups in cardiopulmonary bypass time, aortic crossclamping time, ventilation time, postoperative left ventricle ejection fraction, the length of ICU stay and hospital stay (P>0.05). Blood transfusion ratio, blood transfusion volume and blood loss volume were lower in the minimally invasive group than those in the control group (P<0.05). The length of incision, chest closure time, operative duration were shorter in the minimally invasive group than those in the control group (P<0.05). Conclusion Upper median sternotomy is a safe and feasible procedure for minimally invasive aortic valve replacement surgery. Compared with conventional aortic valve replacement, its advantages include less surgical trauma, stable sternum, rapid recovery, less blood loss and blood transfusion, and cosmetic outcomes.

Citation： SHENGWei, CHIYi-fan, HOUWen-ming, SUNLong, NIUZhao-zhuo, LinMing-shan, YINHong. Minimally Invasive versus Conventional Aortic Valve Replacement Surgery: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 668-671. doi: 10.7507/1007-4848.20150170 Copy

1.	Hiraoka A, Kuinose M, Chikazawa G, et al. Minimally invasive aortic valve replacement surgery:comparison of port-access and conventional standard approach. Circ J, 2011, 75(7):1656-60.
2.	魏来, 王春生, 沈金强. Chitwood法微创心脏瓣膜手术1 15例临床分析. 中华外科杂志, 2011, 49(4):373-375.
3.	金海, 徐志云, 于伟勇, 等. 微创小切口心脏瓣膜手术134例. 中国胸心血管外科临床杂志, 2005, 12(4):237-239.
4.	金海, 于伟勇, 唐昊, 等. 胸骨上段小切口主动脉瓣置换术11例. 中国胸心血管外科临床杂志, 2006, 13(2):120-121.
5.	Castiglioni A, Verzini A, Colangelo N, et al. Comparison of minimally invasive closed circuit versus standard extracorporeal circulation for aortic valve replacement:a randomized study. Interact Cardiovasc Thorac Surg, 2009, 9(1):37-41.
6.	Suri RM, Thalji NM. Minimally invasive heart valve surgery:how and why in 2012. Curr Cardiol Rep, 2012, 14(2):171-179.
7.	高峰, 尤斌, 李平, 等. 微创主动脉瓣置换术及术后早期结果. 中华胸心血管外科杂志, 2012, 28(6):349-351.
8.	TabataM, Umakanthan R, Cohn LH, et al. Early and late outcomes of 1000 minimally invasive aortic valve operations. Eur J Cardiothorac Surg, 2008, 33(4):537-541.
9.	Bakir I, Casselman FP, Wellens F, et al. Minimally invasive versus standard approach aortic valve replacement:a study in 506 patients. Ann Thorac Surg, 2006, 81(5):1599-1604.
10.	Kim BS, Soltesz EG, Cohn LH. Minimally invasive approaches to aortic valve surgery:Brigham experience. Semin Thorac Cardiovasc Surg, 2006, 18(2):148-153.
11.	Vaughan P, Fenwick N, Kumar P. Assisted venous drainage on cardiopulmonary bypass for minimally invasive aortic valve replacement:is it necessary, useful or desirable? Interact Cardiovasc Thorac Surg, 2010, 10(6):868-871.
12.	Johnston WF, Ailawadi G. Surgical management of minimally invasive aortic valve operations. Semin Cardiothorac Vasc Anesth, 2012, 16(1):41-51.
13.	Bang JH, Kim JW, Lee JW, et al. Minimally invasive approaches versus conventional sternotomy for aortic valve replacement:a propensity score matching study. Korean J Thorac Cardiovasc Surg, 2012, 45(2):80-84.
14.	Sharony R, Grossi EA, Saunders PC, et al. Minimally invasive aortic valve surgery in the elderly:a case-control study. Circulation, 2003, 108(Suppl 1):Ⅱ 43-Ⅱ 47.
15.	Plass A, Scheffel H, Alkadhi H, et al. Aortic valve replacement through a minimally invasive approach:preoperative planning, surgical technique, and outcome. Ann Thorac Surg, 2009, 88(6):1851-1856.
16.	Fortunato Júnior JA, Fernandes AG, Sesca JR, et al. Minimally invasive aortic valve replacement:an alternative to the conventional technique. Rev Bras Cir Cardiovasc, 2012, 27(4):570-582.
17.	Boehm J, Libera P, Will A, et al. Partial median "I" sternotomy:minimally invasive alternate approach for aortic valve replacement. Ann Thorac Surg, 2007, 84(3):1053-1055.
18.	肖明第, 程云阁. 微创心脏瓣膜外科的现状与未来. 中国微创外科杂志, 2010, 10(2):99-100.
19.	Leshnower BG, Trace CS, Boova RS. Port-access-assisted aortic valve replacement:a comparison of minimally invasive and conventional techniques. Heart Surg Forum, 2006, 9(2):E560-E56s4.
20.	Kort S, Applebaum RM, Grossi EA, et al. Minimally invasive aortic valve replacement:echocardiographic and clinical results. Am Heart J, 2001, 142(3):476-481.
21.	陈振强, 赵扬, 张辉, 等. 胸骨上段小切口径路行心脏瓣膜手术. 中国胸心血管外科临床杂志, 2005, 12(3):204-205.
22.	何发明, 王平凡, 粱志强, 等. 右腋下小切口心脏直视手术3012例的临床应用. 中国胸心血管外科临床杂志, 2010, 17(3):247-249.
23.	ElBardissi AW, Shekar P, Couper GS, et al. Minimally invasive aortic valve replacement in octogenarian, high-risk, transcatheter aortic valve implantation candidates. J Thorac Cardiovasc Surg, 2011, 141(2):328-335.
24.	Lamelas J, Sarria A, Santana o, et al. Outcomes of minimally invasive valve surgery versus median sternotomy in patients age 75 years or greater. Ann Thorac Surg, 2011, 91(1):79-84.
25.	Schmitto JD, Mohr FW, Cohn LH. Minimally invasive aortic valve replacement:how does this perform in high-risk patients? Curr Opin Cardiol, 2011, 26(2):118-122.

1. Hiraoka A, Kuinose M, Chikazawa G, et al. Minimally invasive aortic valve replacement surgery:comparison of port-access and conventional standard approach. Circ J, 2011, 75(7):1656-60.
2. 魏来, 王春生, 沈金强. Chitwood法微创心脏瓣膜手术1 15例临床分析. 中华外科杂志, 2011, 49(4):373-375.
3. 金海, 徐志云, 于伟勇, 等. 微创小切口心脏瓣膜手术134例. 中国胸心血管外科临床杂志, 2005, 12(4):237-239.
4. 金海, 于伟勇, 唐昊, 等. 胸骨上段小切口主动脉瓣置换术11例. 中国胸心血管外科临床杂志, 2006, 13(2):120-121.
5. Castiglioni A, Verzini A, Colangelo N, et al. Comparison of minimally invasive closed circuit versus standard extracorporeal circulation for aortic valve replacement:a randomized study. Interact Cardiovasc Thorac Surg, 2009, 9(1):37-41.
6. Suri RM, Thalji NM. Minimally invasive heart valve surgery:how and why in 2012. Curr Cardiol Rep, 2012, 14(2):171-179.
7. 高峰, 尤斌, 李平, 等. 微创主动脉瓣置换术及术后早期结果. 中华胸心血管外科杂志, 2012, 28(6):349-351.
8. TabataM, Umakanthan R, Cohn LH, et al. Early and late outcomes of 1000 minimally invasive aortic valve operations. Eur J Cardiothorac Surg, 2008, 33(4):537-541.
9. Bakir I, Casselman FP, Wellens F, et al. Minimally invasive versus standard approach aortic valve replacement:a study in 506 patients. Ann Thorac Surg, 2006, 81(5):1599-1604.
10. Kim BS, Soltesz EG, Cohn LH. Minimally invasive approaches to aortic valve surgery:Brigham experience. Semin Thorac Cardiovasc Surg, 2006, 18(2):148-153.
11. Vaughan P, Fenwick N, Kumar P. Assisted venous drainage on cardiopulmonary bypass for minimally invasive aortic valve replacement:is it necessary, useful or desirable? Interact Cardiovasc Thorac Surg, 2010, 10(6):868-871.
12. Johnston WF, Ailawadi G. Surgical management of minimally invasive aortic valve operations. Semin Cardiothorac Vasc Anesth, 2012, 16(1):41-51.
13. Bang JH, Kim JW, Lee JW, et al. Minimally invasive approaches versus conventional sternotomy for aortic valve replacement:a propensity score matching study. Korean J Thorac Cardiovasc Surg, 2012, 45(2):80-84.
14. Sharony R, Grossi EA, Saunders PC, et al. Minimally invasive aortic valve surgery in the elderly:a case-control study. Circulation, 2003, 108(Suppl 1):Ⅱ 43-Ⅱ 47.
15. Plass A, Scheffel H, Alkadhi H, et al. Aortic valve replacement through a minimally invasive approach:preoperative planning, surgical technique, and outcome. Ann Thorac Surg, 2009, 88(6):1851-1856.
16. Fortunato Júnior JA, Fernandes AG, Sesca JR, et al. Minimally invasive aortic valve replacement:an alternative to the conventional technique. Rev Bras Cir Cardiovasc, 2012, 27(4):570-582.
17. Boehm J, Libera P, Will A, et al. Partial median "I" sternotomy:minimally invasive alternate approach for aortic valve replacement. Ann Thorac Surg, 2007, 84(3):1053-1055.
18. 肖明第, 程云阁. 微创心脏瓣膜外科的现状与未来. 中国微创外科杂志, 2010, 10(2):99-100.
19. Leshnower BG, Trace CS, Boova RS. Port-access-assisted aortic valve replacement:a comparison of minimally invasive and conventional techniques. Heart Surg Forum, 2006, 9(2):E560-E56s4.
20. Kort S, Applebaum RM, Grossi EA, et al. Minimally invasive aortic valve replacement:echocardiographic and clinical results. Am Heart J, 2001, 142(3):476-481.
21. 陈振强, 赵扬, 张辉, 等. 胸骨上段小切口径路行心脏瓣膜手术. 中国胸心血管外科临床杂志, 2005, 12(3):204-205.
22. 何发明, 王平凡, 粱志强, 等. 右腋下小切口心脏直视手术3012例的临床应用. 中国胸心血管外科临床杂志, 2010, 17(3):247-249.
23. ElBardissi AW, Shekar P, Couper GS, et al. Minimally invasive aortic valve replacement in octogenarian, high-risk, transcatheter aortic valve implantation candidates. J Thorac Cardiovasc Surg, 2011, 141(2):328-335.
24. Lamelas J, Sarria A, Santana o, et al. Outcomes of minimally invasive valve surgery versus median sternotomy in patients age 75 years or greater. Ann Thorac Surg, 2011, 91(1):79-84.
25. Schmitto JD, Mohr FW, Cohn LH. Minimally invasive aortic valve replacement:how does this perform in high-risk patients? Curr Opin Cardiol, 2011, 26(2):118-122.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Minimally Invasive versus Conventional Aortic Valve Replacement Surgery: A Case Control Study

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content