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Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes

INTRODUCTION: aortic valve replacement is usually performed through a median full sternotomy (MFS) in our department. Minimally invasive aortic valve replacement (MIAVR) has been recently adopted as a new approach. According to the literature, the superiority of MIAVR is controversial. In this study...

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Autores principales: Zallé, Issaka, Son, Moussa, El-Alaoui, Mohamed, Nijimbéré, Macédoine, Boumzebra, Drissi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590260/
https://www.ncbi.nlm.nih.gov/pubmed/34804336
http://dx.doi.org/10.11604/pamj.2021.40.68.28008
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author Zallé, Issaka
Son, Moussa
El-Alaoui, Mohamed
Nijimbéré, Macédoine
Boumzebra, Drissi
author_facet Zallé, Issaka
Son, Moussa
El-Alaoui, Mohamed
Nijimbéré, Macédoine
Boumzebra, Drissi
author_sort Zallé, Issaka
collection PubMed
description INTRODUCTION: aortic valve replacement is usually performed through a median full sternotomy (MFS) in our department. Minimally invasive aortic valve replacement (MIAVR) has been recently adopted as a new approach. According to the literature, the superiority of MIAVR is controversial. In this study we report early post-operative outcomes in MIAVR compared with MFS access with reference to blood Loss, wound infections, post-operative recovery, morbidity and mortality. METHODS: this study was a prospective data collection from 36 consecutive patients undergoing isolated valve replacement. Two population study was identified, MIAVR group (group I n=18) and MFS group (group II n=18). Patients´ data were collected and analyzed using IBM SPSS statistics 21 software and Khi2 test has been used to compare the variables. The study variables are presented as numbers, percentage, median with interquartile range. Pre-operative planning was performed so that to obtain similar characteristics. RESULTS: in group I, upper mini-sternotomy was used in 12 patients and right mini-thoracotomy in 6 patients. There was no difference in term of mortality and morbidity. MIAVR was associated with longer CPB time (93.25 (58-161) vs 131 (75-215) mins, P=0.047) with no significant difference in term of ACC time (81 (33-162) vs 58.8 (59-102) mins P=0.158). MIAVR´ Patients had likely lower incidence of red blood cells transfusion (16.7 vs 52.3%) without significant difference about post-operative haemoglobin (P = 0,330). Patients in group I had shorter ventilation time (2.35 (1-12) vs 9.3 (1-48) hours P < 0.01), shorter ICU stay (2.44 (1-8) vs 4.25 (1-9) days, P = 0,024). The length of hospital stay was shorter, 6.5 (5-9) days in group I vs 7.4 (6-11), P=0.0274. Length of chest tube stay was shorter in group I (mean 1.53 vs 2.4 days, P=0,033). Wound infections were not found in both groups. CONCLUSION: minimally invasive aortic valve replacement is associated with less blood loss, faster post-operative recovery faster post-operative recovery but increase operation time.
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spelling pubmed-85902602021-11-18 Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes Zallé, Issaka Son, Moussa El-Alaoui, Mohamed Nijimbéré, Macédoine Boumzebra, Drissi Pan Afr Med J Research INTRODUCTION: aortic valve replacement is usually performed through a median full sternotomy (MFS) in our department. Minimally invasive aortic valve replacement (MIAVR) has been recently adopted as a new approach. According to the literature, the superiority of MIAVR is controversial. In this study we report early post-operative outcomes in MIAVR compared with MFS access with reference to blood Loss, wound infections, post-operative recovery, morbidity and mortality. METHODS: this study was a prospective data collection from 36 consecutive patients undergoing isolated valve replacement. Two population study was identified, MIAVR group (group I n=18) and MFS group (group II n=18). Patients´ data were collected and analyzed using IBM SPSS statistics 21 software and Khi2 test has been used to compare the variables. The study variables are presented as numbers, percentage, median with interquartile range. Pre-operative planning was performed so that to obtain similar characteristics. RESULTS: in group I, upper mini-sternotomy was used in 12 patients and right mini-thoracotomy in 6 patients. There was no difference in term of mortality and morbidity. MIAVR was associated with longer CPB time (93.25 (58-161) vs 131 (75-215) mins, P=0.047) with no significant difference in term of ACC time (81 (33-162) vs 58.8 (59-102) mins P=0.158). MIAVR´ Patients had likely lower incidence of red blood cells transfusion (16.7 vs 52.3%) without significant difference about post-operative haemoglobin (P = 0,330). Patients in group I had shorter ventilation time (2.35 (1-12) vs 9.3 (1-48) hours P < 0.01), shorter ICU stay (2.44 (1-8) vs 4.25 (1-9) days, P = 0,024). The length of hospital stay was shorter, 6.5 (5-9) days in group I vs 7.4 (6-11), P=0.0274. Length of chest tube stay was shorter in group I (mean 1.53 vs 2.4 days, P=0,033). Wound infections were not found in both groups. CONCLUSION: minimally invasive aortic valve replacement is associated with less blood loss, faster post-operative recovery faster post-operative recovery but increase operation time. The African Field Epidemiology Network 2021-09-30 /pmc/articles/PMC8590260/ /pubmed/34804336 http://dx.doi.org/10.11604/pamj.2021.40.68.28008 Text en Copyright: Issaka Zallé et al. https://creativecommons.org/licenses/by/4.0/The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Zallé, Issaka
Son, Moussa
El-Alaoui, Mohamed
Nijimbéré, Macédoine
Boumzebra, Drissi
Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
title Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
title_full Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
title_fullStr Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
title_full_unstemmed Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
title_short Minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
title_sort minimally invasive and full sternotomy in aortic valve replacement: a comparative early operative outcomes
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590260/
https://www.ncbi.nlm.nih.gov/pubmed/34804336
http://dx.doi.org/10.11604/pamj.2021.40.68.28008
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