Operative outcome of minimal access aortic valve replacement versus standard procedure.
BACKGROUND
to determine the advantages and/or risks of minimal access aortic valve replacement compared to standard sternotomy procedure.


METHODS
from January 1997 to December 2001, 271 consecutive adult patients underwent isolated aortic valve replacement of which 174 underwent a minimal access procedure (Group 1) and 97 a standard procedure (Group 2). The preoperative variables of both groups were comparable. Retrospective analysis of postoperative outcome was performed.


RESULTS
follow-up was complete and ranged from 6 months to 4 years. Overall in-hospital mortality was 3.3% (respectively 2.8 and 4.1%). No statistical difference was noted regarding operative time variables, mortality rate and hospital stay. There was a significant higher incidence of revision (p = 0.018) and late pericardial effusion (p = 0.022) in the minimal access group. Also trends were in favour of the standard group for incidence of postoperative pneumothorax and pericarditis constrictiva.


CONCLUSIONS
minimal access aortic valve replacement is a safe and reliable technique, but carries the risk of incision-related morbidity. Proper patient selection and perioperative management is mandatory.
Department of Cardiac Surgery, University Hospital Gent, Gent, Belgium. hans.vanoverbeke@rug.ac.be
H
H
Vanoverbeke
Y
Y
Van Belleghem
K
K
Francois
F
F
Caes
T
T
Bové
G
G
Van Nooten
D000368:Aged; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010490:Pericardial Effusion / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome