Isolated and concomitant minimally invasive minithoracotomy aortic valve surgery

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Minimally Invasive Procedures

Background:

• Aortic valve replacement (AVR) is a critical procedure for managing aortic valve disease.
• Minimally invasive techniques offer potential benefits over traditional sternotomy.
• Evaluating outcomes across different age groups and surgical complexities is essential.

Purpose of the Study:

• To compare outcomes of minimally invasive AVR in younger versus older patients.
• To assess the safety and risks of concomitant AVR procedures in these populations.
• To determine the feasibility of minimally invasive AVR via right minithoracotomy.

Main Methods:

• Retrospective analysis of 1018 isolated AVR and 378 concomitant AVR cases over 6 years.
• All surgeries performed using a right minithoracotomy approach.
• Exclusion of reoperation cases.

Main Results:

• Low 30-day mortality (1.3% isolated, 3.2% concomitant) and stroke rates (0.8% isolated, 1.1% concomitant).
• Similar mortality rates between younger (<80) and older (≥80) patients in both isolated and concomitant AVR groups.
• Older patients experienced higher rates of transfusion, longer ICU/hospital stays, and more atrial fibrillation.

Conclusions:

• Minimally invasive right thoracotomy AVR is associated with low mortality and stroke rates across all age groups.
• Concomitant AVR via minithoracotomy is feasible and safe, even in patients with multiple comorbidities.
• Age is not a significant risk factor for mortality in minimally invasive AVR, though older patients may require more resources.