Aortic valve replacement through minithoracotomy. Results from the Peruvian experience

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Valve Surgery

Background:

• Aortic valve replacement (AVR) is a critical procedure for managing aortic valve disease.
• Minimally invasive approaches like mini-thoracotomy (MT) are gaining traction for AVR.
• Assessing outcomes of AVR via MT is essential for patient selection and procedural refinement.

Purpose of the Study:

• To evaluate mortality, major valve-related events (MAVRE), and other complications after AVR using mini-thoracotomy (MT).
• To assess long-term functional status and safety of AVR through MT in a specific patient cohort.

Main Methods:

• Retrospective analysis of patients under 80 years undergoing AVR via MT between 2017-2021.
• Exclusion of patients with other surgical approaches, concomitant procedures, redo, or emergency surgeries.
• Data collection on MAVRE, mortality, and clinical variables at 30 days and 12-month follow-up.

Main Results:

• Fifty-four patients (median age 69.5 years, 65% female) were studied, primarily for aortic stenosis (65%).
• Low 30-day MAVRE rate (3.7%) with no in-hospital mortality; one stroke and one pacemaker implantation occurred.
• No reoperations for prosthesis dysfunction or endocarditis; sustained functional improvement (NYHA I/II) at 1-year follow-up.

Conclusions:

• Aortic valve replacement through mini-thoracotomy is a safe and effective procedure in selected patients under 80 years.
• The procedure demonstrates favorable short-term and mid-term outcomes regarding MAVRE and functional status.
• Mini-thoracotomy offers a viable minimally invasive option for aortic valve replacement in this patient demographic.