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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Outcomes of Minimally Invasive Valve Surgery in Patients with Multiple Previous Cardiac Operations
Orlando Santana1, Rama Krishna1, Nisharahmed Kherada1
1Columbia University, Mount Sinai Heart Institute, Miami Beach FL, USA.
The Journal of Heart Valve Disease
|December 24, 2016
Summary
Minimally invasive reoperative valve surgery is safe for patients with multiple prior cardiac surgeries. This approach offers good perioperative outcomes and mid-term survival rates.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Evaluating outcomes of minimally invasive valve surgery in patients with extensive prior cardiac operations.
- Focus on right anterior thoracotomy approach for reoperative valve procedures.
Purpose of the Study:
- Assess safety and feasibility of minimally invasive valve surgery in patients with >2 prior cardiac surgeries.
- Analyze perioperative outcomes and mid-term survival in this high-risk cohort.
Main Methods:
- Retrospective review of minimally invasive valve operations.
- Inclusion criteria: patients with ≥2 prior cardiac surgeries (coronary artery bypass grafting and/or valve surgery).
- Data collected between January 2008 and November 2014.
Main Results:
- 38 patients identified with complex surgical histories.
- Common procedures included mitral and aortic valve operations.
- Perioperative complications: cerebrovascular accidents (5.3%), reoperation for bleeding (7.9%), acute kidney injury (7.9%).
- 30-day mortality: 7.9%.
- 5-year survival: 72%.
Conclusions:
- Minimally invasive reoperative valve surgery is safe and feasible in patients with multiple prior cardiac operations.
- The approach demonstrates good perioperative results.
- Favorable mid-term survival rates support this technique for selected patients.
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