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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
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Minimally Invasive Aortic Valve Surgery in Octogenarians: Reliable Option or Fallback Solution?
Federico Cammertoni1, Piergiorgio Bruno1, Raphael Rosenhek2
160234 Cardiac Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Innovations (Philadelphia, Pa.)
|December 15, 2020
Summary
Minimally invasive aortic valve replacement (MIAVR) offers advantages for octogenarians, including shorter ventilation and hospital stays, with comparable survival to conventional aortic valve replacement (CAVR). Both approaches provide excellent outcomes in selected older patients.
Area of Science:
- Cardiac Surgery
- Thoracic Surgery
- Geriatric Medicine
Background:
- Aortic valve disease is increasingly prevalent in Western countries.
- Surgical aortic valve replacement is a common treatment for older adults.
- Minimally invasive approaches may offer benefits for elderly patients.
Purpose of the Study:
- To compare outcomes of conventional aortic valve replacement (CAVR) and minimally invasive aortic valve replacement (MIAVR) in octogenarians.
- To evaluate the safety and efficacy of MIAVR in elderly patients undergoing aortic valve surgery.
Main Methods:
- Retrospective analysis of 75 octogenarians undergoing primary, elective, isolated aortic valve surgery.
- Patients were divided into two groups: CAVR (41 patients) and MIAVR (34 patients) via partial upper sternotomy.
- Data collected included perioperative outcomes and mid-term survival.
Main Results:
- MIAVR group showed significantly lower 24-hour chest drain output, shorter mechanical ventilation duration, and reduced blood transfusion rates.
- Hospital stay was shorter in the MIAVR group compared to the CAVR group.
- No significant difference in 30-day mortality or mid-term survival (1, 3, and 5 years) between the two groups.
Conclusions:
- Aortic valve surgery in carefully selected octogenarians yields excellent results.
- MIAVR is associated with improved perioperative outcomes, including reduced ventilation, blood transfusions, and hospitalization.
- MIAVR does not compromise perioperative safety or mid-term survival compared to CAVR in octogenarians.
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