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Related Concept Videos

Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Related Experiment Video

Updated: Aug 16, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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In-Hospital Mortality and Risk Prediction in Minimally Invasive Sutureless versus Conventional Aortic Valve

Giuseppe Santarpino1,2,3, Roberto Lorusso4, Armin Darius Peivandi5

  • 1Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy.

Journal of Clinical Medicine
|December 23, 2022
PubMed
Summary

Minimally invasive sutureless aortic valve replacement (AVR) significantly reduces in-hospital mortality compared to conventional AVR. This approach shows favorable immediate outcomes, though EuroSCORE II may not accurately predict results in this group.

Keywords:
aortic stenosisaortic valve replacementminimally invasive surgerysutureless valves

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Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Patient Outcomes

Background:

  • Conventional aortic valve replacement (AVR) often involves median sternotomy.
  • Sutureless bioprostheses offer a potentially less invasive alternative.
  • Evidence suggests a positive impact of minimally invasive AVR on patient outcomes.

Purpose of the Study:

  • To compare the outcomes of conventional AVR with stented bioprostheses versus minimally invasive AVR with sutureless bioprostheses.
  • To evaluate the effectiveness and safety of sutureless bioprostheses in AVR procedures.
  • To assess the predictive accuracy of EuroSCORE II in minimally invasive AVR.

Main Methods:

  • A retrospective analysis of 2732 patients undergoing AVR from 2010 to 2019.
  • Comparison between conventional AVR with stented bioprostheses (n=2048) and minimally invasive AVR with sutureless bioprostheses (n=684).
  • Propensity score matching was used to create balanced groups for analysis.

Main Results:

  • Minimally invasive sutureless AVR demonstrated significantly lower in-hospital mortality rates (0.88% vs 2.54% unmatched, 0.97% vs 2.43% matched).
  • Shorter cross-clamp times were observed in the sutureless + minimally invasive group.
  • No significant difference in postoperative pacemaker implantation rates between groups.

Conclusions:

  • Minimally invasive sutureless AVR is associated with improved immediate outcomes and reduced in-hospital mortality compared to conventional AVR.
  • The EuroSCORE II may have diminished discriminatory power for predicting outcomes in patients undergoing minimally invasive sutureless AVR.
  • Sutureless bioprostheses represent a viable option for minimally invasive aortic valve replacement.