Aortic valve replacement with minimal extracorporeal circulation versus standard cardiopulmonary bypass.
The purpose of this study was to evaluate the safety and the clinical outcomes of aortic valve replacement (AVR) performed with minimally invasive extracorporeal circulation (miniECC) technique vs. standard cardiopulmonary bypass (CPB). From February 2006 to December 2007 a total of 181 isolated AVR were performed, of these 53 patients were operated using minimal extracorporeal circulation system and 128 patients were operated using the standard CPB. Demographic characteristics and operative data were similar in both groups except for EuroSCORE (P<0.0001). Operative mortality (<30 days) was 3.8% for miniECC group and 4.7% for CPB group (P=ns). Patients in both groups showed similar postoperative chest tube drainage (432+/-325 ml vs. 460+/-331 ml, P=ns). The percentage of transfused patients was similar in both groups (37.7% vs. 43.8%, P=0.45). The number of transfused blood bank products was higher in patients with a body surface area >1.7 m(2) and who underwent traditional CPB in respect to miniECC system. Postoperatively renal injury, atrial fibrillation episodes, neurologic event rate, ICU and hospital stay length were similar in both groups. The miniECC is suitable for AVR providing good clinical results but the present results should not identify the miniECC system to be superior to the conventional CPB.
Colli
Andrea
A
Department of Cardiac Surgery, Hospital Universitari Germans Trias i Pujols, Ctra. Canyet Sn, 08916 Badalona, Barcelona, Spain. colli.andrea.bcn@gmail.com
Fernandez
Claudio
C
Delgado
Luis
L
Romero
Bernardo
B
Camara
Maria Luisa
ML
Ruyra
Xavier
X
D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D001281:Atrial Fibrillation / Q000209:etiology; D001803:Blood Transfusion; D001830:Body Surface Area; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000401:mortality; D015505:Chest Tubes; D003422:Critical Care; D004322:Drainage / Q000295:instrumentation; D005112:Extracorporeal Circulation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome