title: Long-Term Outcomes after Minimally Invasive Aortic Valve Surgery through Right Anterior Minithoracotomy.
abstract: BackgroundMinimally invasive aortic valve surgery (MIAV) through a right anterior minithoracotomy evolved to an accepted procedure with favorable short- and mid-term outcomes, whereas long-term results lack. The aim of this study was to evaluate the long-term outcomes.Materials and MethodsAll our MIAV patients were included (n= 225). Mean age was 68 ± 12 years, 29% were older than 75 years, and median EuroSCORE was 5 (0-11). Baseline characteristics, inhospital outcomes, and follow-up information about survival, major adverse cardiac and cerebrovascular events (MACCE), and need for reoperation were collected and analyzed.ResultsIn this study, 30-day mortality was 1.3%, and there was no permanent stroke. Mean follow-up time was 69.65 ± 24 months, being the longest so far reported in the literature. At 1 and 7 years, survival was 95.8 and 79%, freedom from MACCE 98.1 and 95.7%, and from reoperation 99.5 and 98.7%, respectively.ConclusionMIAV is safe and feasible with favorable long-term outcomes. In the future, it could serve as benchmark for interventional methods as soon as indications are expanded to young and low-risk patients. Randomized studies are needed to compare the long-term outcomes of these approaches.
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Diana
authors: D
authors: Reser
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Roman
authors: R
authors: Walser
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Mathias
authors: M
authors: van Hemelrijk
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Tomas
authors: T
authors: Holubec
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Alberto
authors: A
authors: Weber
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: André
authors: A
authors: Plass
authors: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors: Francesco
authors: F
authors: Maisano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013557:Switzerland; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome