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Minimal access aortic surgery including re-operations.

L G Svensson1, E M Nadolny, W A Kimmel

  • 1Center for Aortic Surgery, Lahey Clinic, MA, Burlington, USA. lars.g.svensson@lahey.org

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 13, 2001
PubMed
Summary

Minimal access aortic surgery, including for re-operations, shows a 96% survival rate with acceptable complication rates. This approach is recommended, especially for repeat surgeries, due to reasonable intensive care unit (ICU) and hospital stays.

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Techniques
  • Aortic Surgery

Background:

  • Minimal access ascending aorta and aortic arch surgery, including re-operations, lacks comprehensive safety and benefit data.
  • Evaluating outcomes for these complex procedures is crucial for surgical decision-making.

Purpose of the Study:

  • To assess the safety and benefits of minimal access ascending aorta and aortic arch surgery.
  • To evaluate outcomes specifically for re-operations using a minimal access approach.

Main Methods:

  • A retrospective evaluation of 54 patients undergoing minimal access aortic surgery.
  • Procedures included valve replacements (76%), re-operations (33%), composite valve grafts (28%), and elephant trunk procedures (6%).

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Main Results:

  • High survival rate of 96% (52 patients) with low rates of stroke (3.7%) and neurocognitive deficit (1.8%).
  • Average circulatory arrest time was 20 min, aortic crossclamp time 91 min, and cardiopulmonary bypass time 132 min.
  • Intensive care unit (ICU) and postoperative hospital stay were 1.8 and 6.7 days, respectively. No deaths occurred in re-operation patients.

Conclusions:

  • Minimal access aortic surgery is associated with acceptable risks and reasonable ICU/hospital stays.
  • The technique is technically demanding but recommended, particularly for re-operative cases.