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Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity
OBJECTIVES: Limited aortic annulus exposure during minimal invasive aortic valve replacement (mini-AVR) proves to be challenging and contributes to procedure complexity, resulting in longer procedure times. New innovations like sutureless valves have been introduced to reduce procedure complexity. A...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790021/ https://www.ncbi.nlm.nih.gov/pubmed/31606041 http://dx.doi.org/10.1186/s13019-019-0997-5 |
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author | Boti, Bruce R. Hindori, Vikash G. Schade, Emilio L. Kougioumtzoglou, Athina M. Verbeek, Eva C. Driessen-Waaijer, Annet Cocchieri, Riccardo de Mol, Bas A. J. M. Planken, Nils R. Kaya, Abdullah Marquering, Henk A. |
author_facet | Boti, Bruce R. Hindori, Vikash G. Schade, Emilio L. Kougioumtzoglou, Athina M. Verbeek, Eva C. Driessen-Waaijer, Annet Cocchieri, Riccardo de Mol, Bas A. J. M. Planken, Nils R. Kaya, Abdullah Marquering, Henk A. |
author_sort | Boti, Bruce R. |
collection | PubMed |
description | OBJECTIVES: Limited aortic annulus exposure during minimal invasive aortic valve replacement (mini-AVR) proves to be challenging and contributes to procedure complexity, resulting in longer procedure times. New innovations like sutureless valves have been introduced to reduce procedure complexity. Additionally, preoperative imaging could also contribute to reducing procedure times. Therefore, we hypothesize that Computed Tomography (CT)-image based measurements are associated with mini-AVR complexity. METHODS: One hundred patients who underwent a mini-sternotomy and had a preoperative CT scan were included. With a CT-based mini-AVR planning tool, we measured access distance, access angle, annulus dimensions, and calcium volume. The associations of these measurements with cardiopulmonary bypass (CPB) time and aortic cross-clamp (AoX) time were assessed using univariable and multivariable regression models. In the multivariable models, these measurements were adjusted for age and suture technique. RESULTS: In the univariable regression models, calcium volume and annulus dimensions were associated with longer CPB and AoX time. After adjusting for age and suture technique, increasing calcium volume was still associated with longer CPB (adjusted β-coefficient 0.002, 95%-CI (0.005, 0.019), p-value = 0.002) and AoX time (adjusted β-coefficient 0.010, 95%-CI (0.004, 0.016), p-value = 0.002). However, after adjusting for these confounders, the association between annulus dimensions and procedure times lost statistical significance. CONCLUSION: Increase in calcium volume are associated with longer CPB and AoX times, with age and sutureless valve implantation as independent confounders. In contrast to previous studies, access angle was not associated with procedure complexity. |
format | Online Article Text |
id | pubmed-6790021 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67900212019-10-18 Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity Boti, Bruce R. Hindori, Vikash G. Schade, Emilio L. Kougioumtzoglou, Athina M. Verbeek, Eva C. Driessen-Waaijer, Annet Cocchieri, Riccardo de Mol, Bas A. J. M. Planken, Nils R. Kaya, Abdullah Marquering, Henk A. J Cardiothorac Surg Research Article OBJECTIVES: Limited aortic annulus exposure during minimal invasive aortic valve replacement (mini-AVR) proves to be challenging and contributes to procedure complexity, resulting in longer procedure times. New innovations like sutureless valves have been introduced to reduce procedure complexity. Additionally, preoperative imaging could also contribute to reducing procedure times. Therefore, we hypothesize that Computed Tomography (CT)-image based measurements are associated with mini-AVR complexity. METHODS: One hundred patients who underwent a mini-sternotomy and had a preoperative CT scan were included. With a CT-based mini-AVR planning tool, we measured access distance, access angle, annulus dimensions, and calcium volume. The associations of these measurements with cardiopulmonary bypass (CPB) time and aortic cross-clamp (AoX) time were assessed using univariable and multivariable regression models. In the multivariable models, these measurements were adjusted for age and suture technique. RESULTS: In the univariable regression models, calcium volume and annulus dimensions were associated with longer CPB and AoX time. After adjusting for age and suture technique, increasing calcium volume was still associated with longer CPB (adjusted β-coefficient 0.002, 95%-CI (0.005, 0.019), p-value = 0.002) and AoX time (adjusted β-coefficient 0.010, 95%-CI (0.004, 0.016), p-value = 0.002). However, after adjusting for these confounders, the association between annulus dimensions and procedure times lost statistical significance. CONCLUSION: Increase in calcium volume are associated with longer CPB and AoX times, with age and sutureless valve implantation as independent confounders. In contrast to previous studies, access angle was not associated with procedure complexity. BioMed Central 2019-10-12 /pmc/articles/PMC6790021/ /pubmed/31606041 http://dx.doi.org/10.1186/s13019-019-0997-5 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Boti, Bruce R. Hindori, Vikash G. Schade, Emilio L. Kougioumtzoglou, Athina M. Verbeek, Eva C. Driessen-Waaijer, Annet Cocchieri, Riccardo de Mol, Bas A. J. M. Planken, Nils R. Kaya, Abdullah Marquering, Henk A. Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
title | Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
title_full | Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
title_fullStr | Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
title_full_unstemmed | Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
title_short | Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
title_sort | minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790021/ https://www.ncbi.nlm.nih.gov/pubmed/31606041 http://dx.doi.org/10.1186/s13019-019-0997-5 |
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