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Minimally invasive aortic valve replacement: Comparison of long-term outcomes

Priyadharshanan Ariyaratnam1, Mahmoud Loubani2, Steven C Griffin2

  • 1Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK priyadariyaratnam@yahoo.co.uk.

Asian Cardiovascular & Thoracic Annals
|May 21, 2015
PubMed

Insights

Minimally invasive aortic valve replacement shows comparable short-term outcomes to conventional surgery. Long-term survival is favorable, supporting its continued use by specialist surgeons.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Procedures

Background:

  • Minimally invasive aortic valve replacement (MIAVR) is typically performed in specialized centers.
  • Limited data exists on the long-term outcomes of the upper hemi-sternotomy technique for MIAVR.

Purpose of the Study:

  • To evaluate the short- and long-term outcomes of upper hemi-sternotomy minimally invasive aortic valve replacement.
  • To compare MIAVR outcomes with conventional aortic valve replacement (CAVR) at an institutional level.

Main Methods:

  • A retrospective review of patients undergoing MIAVR or CAVR between July 1999 and December 2013.
  • Propensity score matching was used to compare hospital outcomes between the two groups.

Main Results:

  • 125 patients underwent MIAVR and 1446 underwent CAVR. Propensity matching revealed no significant differences in postoperative mortality or complications.
  • Conventional surgery had longer bypass and crossclamp times. Long-term survival rates for MIAVR at 2, 6, and 10 years were 88%, 79%, and 66%, respectively.
  • Predictors of long-term survival included age, peripheral vascular disease, and low ejection fraction.

Conclusions:

  • Minimally invasive aortic valve replacement demonstrates similar hospital outcomes to conventional aortic valve replacement.
  • MIAVR is associated with shorter operative times without increased complications or hospital stay.
  • Favorable long-term outcomes support the continued use of MIAVR by specialist surgeons.
Abstract

Keywords:
Aortic valve insufficiencyAortic valve stenosisHeart valve prosthesis implantationMinimally invasive surgical proceduresTreatment outcome

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