Minimally Invasive Versus Conventional Aortic Root Replacement - A Systematic Review and Meta-Analysis

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Mini-sternotomy shows superior perioperative outcomes in aortic valve replacement.
• The efficacy of mini-sternotomy in aortic root surgery remains under investigation.

Purpose of the Study:

• To compare the outcomes of mini-sternotomy versus full sternotomy in patients undergoing aortic root surgery.

Main Methods:

• A systematic literature search was conducted across PubMed, Ovid, Scopus, and EMBASE up to June 2018.
• Meta-analysis included eight comparative studies involving 2,765 patients.

Main Results:

• Mini-sternotomy was associated with significantly shorter cardiopulmonary bypass time, lower blood transfusion rates, reduced operative mortality, and shorter ICU/hospital stays.
• No significant differences were observed in aortic cross-clamp time, total operation time, re-exploration rates, stroke, wound infection, or ventilation duration.

Conclusions:

• Mini-sternotomy is a safe and feasible alternative for aortic root repair.
• The current evidence is limited by heterogeneity, necessitating larger, well-designed trials.