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Long-term follow-up of minimally invasive cardiac surgery using an endoaortic occlusion system
Arndt-H Kiessling1, Philipp Kisker1, Alexandra Miskovic1
1Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt Goethe University, Frankfurt am Main, Germany.
Insights
The endoaortic occlusion system is safe for minimally invasive cardiac surgery, showing no aortic damage or reduced quality of life in patients undergoing procedures like coronary artery bypass grafting (CABG).
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Procedures
Background:
- The endoaortic occlusion system exerts significant pressure on the aortic wall during cardiac procedures.
- Potential for late aortic degeneration and aneurysm formation necessitates evaluation.
Purpose of the Study:
- To assess postoperative aortic complications after using the endoaortic occlusion system.
- To evaluate the quality of life in patients who underwent minimally invasive cardiac surgery with this system.
Main Methods:
- Review of 116 patients undergoing minimally invasive procedures (CABG, mitral valve surgery, ASD closure) using an endoaortic clamp.
- Echocardiographic examination after a mean follow-up of 8.8 years.
- Analysis of 78 patients for aortic structural integrity and quality of life (SF-12).
Main Results:
- No incidence of structural damage to the ascending aorta was observed at the clamp's intraoperative position.
- Physical and mental health scores were comparable to conventional surgery patient groups.
Conclusions:
- The endoaortic occlusion system does not cause aortic wall damage.
- Any complications related to the system occur intraoperatively.
- Minimally invasive surgery with this system yields a quality of life similar to conventional surgery.
Objectives:
We reviewed the initial patient series (n=116) of our institution performing minimally invasive coronary artery bypass grafting (CABG) (n=79), mitral valve surgery (n=1), or atrial septal closure (ASD) procedures (n=26) using an endoaortic occlusion system. With this technique relevant intra-aortic pressures are exerted on the aortic wall during the clamping time. This might lead to late aortic degeneration and aneurysm formation. Our study sought to evaluate postoperative aortic complications and the quality of life (modified SF-12).
Methods:
One hundred sixteen patients (56% male; 54 years ± 14.5; range 19 years to 77 years) underwent a cardiac procedure using an endoaortic clamp. The endoaortic balloon clamp catheter was used to occlude the ascending aorta at pressures >300 mmHg. Patients were rescheduled for echocardiographic examination after a mean follow-up period of 8.8 years.
Results:
The analysis performed among 78 patients showed no incidence of any structural damage to the ascending aorta at the intraoperative position of the endoaortic balloon. The physical and mental summary scores are equal to those of comparable patient groups.
Conclusions:
The endoaortic occlusion system causes no damage to the aortic wall. If the system causes any problems, they occur immediately during surgery. Patients treated with this minimally invasive technique exhibited the same quality of life as those undergoing conventional surgery.
