Related Experiment Video

Updated: Aug 21, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

11.8K

Minimally invasive versus conventional aortic valve replacement: The network meta-analysis

Takuya Ogami1, Yujiro Yokoyama2, Hisato Takagi3

  • 1Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Journal of Cardiac Surgery
|November 15, 2022
PubMed
Abstract

Insights

Minimally invasive mini-sternotomy (MS) offers potentially better short-term outcomes for surgical aortic valve replacement (SAVR) compared to full sternotomy (FS) or right mini-thoracotomy (RMT). Mid-term mortality was similar across all surgical aortic valve replacement approaches.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Background:

  • Conflicting outcomes reported for surgical aortic valve replacement (SAVR) comparing minimally invasive approaches (mini-sternotomy [MS], right mini-thoracotomy [RMT]) with full sternotomy (FS).
  • Lack of synthesized mid-term mortality data for these SAVR approaches.

Purpose of the Study:

  • To compare outcomes of SAVR across FS, MS, and RMT incisional approaches.
  • To synthesize mid-term mortality data for SAVR procedures.

Main Methods:

  • Systematic literature search of MEDLINE and EMBASE up to April 2022.
  • Inclusion of propensity score matched (PSM) studies and randomized controlled trials (RCTs).
  • Network analysis using a random effects model to compare FS, MS, and RMT outcomes.

Main Results:

  • Analysis of 42 studies with 14,925 patients.
  • Lower operative mortality observed with MS compared to FS and RMT.
  • Higher risk of reoperation for bleeding with RMT versus MS.
  • Shorter hospital length of stay with MS compared to FS; no significant difference between FS and RMT.
  • Similar mid-term (1-year) mortality across all three approaches.

Conclusions:

  • Mini-sternotomy (MS) may be a safer and more effective short-term approach for SAVR than full sternotomy (FS) or right mini-thoracotomy (RMT).
  • Mid-term mortality is comparable among the three SAVR incisional approaches.
Keywords:
aortic valve replacementmini-sternotomythoracotomy

More Related Videos

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.2K
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

11.4K

Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
32
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
16
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
36
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
25
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
25