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Titolo:
Minimally-invasive versus conventional aortic valve replacement - perioperative course and mid-term results
Autore:
Christiansen, S; Stypmann, J; Tjan, TDT; Wichter, T; Van Aken, H; Scheld, HH; Hammel, D;
Indirizzi:
Univ Munster, Klin & Poliklin Thorax Herz & Gefasschirurg, D-48149 Munster, Germany Univ Munster Munster Germany D-48149 sschirurg, D-48149 Munster, Germany
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 6, volume: 16, anno: 1999,
pagine: 647 - 652
SICI:
1010-7940(199912)16:6<647:MVCAVR>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSESOPHAGEAL ECHOCARDIOGRAPHY; BIOPROSTHETIC VALVES; PARTIAL STERNOTOMY; OPERATIONS; SURGERY; INCISION;
Keywords:
aortic valve replacement; minimally invasive surgery; cardiac surgery; perioperative course; mid-term results;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Christiansen, S Univ Munster, Klin & Poliklin Thorax Herz & Gefasschirurg,Albert Schweitzer Str 33, D-48149 Munster, Germany Univ Munster Albert Schweitzer Str 33 Munster Germany D-48149
Citazione:
S. Christiansen et al., "Minimally-invasive versus conventional aortic valve replacement - perioperative course and mid-term results", EUR J CAR-T, 16(6), 1999, pp. 647-652

Abstract

Objective: We performed a case-control-study to compare perioperative and mid-term results of minimally invasive with conventional aortic valve replacement. Methods: Between 8/96 and 7/97, 113 patients underwent isolated aortic valve replacement (minimally invasive: 29, conventional: 84) in our Department. Diagnosis, ejection fraction, pressure gradient/regurgitation fraction, age, gender and body-mass-index were used as matching criteria for the case-control-study. For qualitative data correspondence was requested, for quantitative data deviations up to 10% were accepted. With these criteria25 patients of the minimally invasive group were matched to 25 patients ofconventional group. All patients were reexplored 1 year after aortic valvereplacement. Statistical analysis was done by the Fisher's exact test for qualitative data and the Mann-Whitney test for quantitative data. Results: We implanted 15 (20) bioprosthesis' and 10 (five) mechanical prosthesis' inthe minimally invasive, respectively, conventional group. There were no statistically significant differences between both groups with respect to theperioperative course, only duration of surgery (mean 201.6 vs. 143.9 min, P < 0.01) and extracorporeal circulation (mean 116.1 vs. 71.3 min, P < 0.01) as well as aortic-cross-clamp-time (mean 77.9 vs. 46.9 min, P < 0.01) were significantly longer in the minimally invasive group. Postoperative complications occurred in one patient of the minimally invasive group (dissection of the right coronary artery) and four patients of the conventional group(third degree AV block, pneumothorax, grand mal convulsion, cardiopulmonary resuscitation). Two patients, one of each group, died during follow-up for unknown reasons. Follow-up revealed no significant differences with respect to clinical and echocardiographic data, but the shorter skin incision was cosmetically more accepted by patients of the minimally invasive group. Minor paravalvular leaks occurred in four patients of the minimally invasiveand three patients of the conventional group as diagnosed by transthoracicechocardiography. Conclusions: Both surgical techniques may be performed with comparable perioperative and mid-term results, but the better cosmetic result in the minimally invasive group is paid by a longer duration of surgery. (C) 1999 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 17:28:25