Minimally Invasive Endoscopic Aortic Valve Replacement: Operative Results

Cresce, Giovanni Domenico; Sella, Massimo; Danesi, Tommaso Hinna; Favaro, Alessandro; Salvador, Loris

doi:10.1053/j.semtcvs.2020.01.002

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…However, a study by Tokoro M et al indicated that all-thoracoscopic AVR had similar CPB and AC times compared to conventional AVR [9] . Cresce GD et al showed that the type of valve may have a significant effect on CPB and AC time, and we were failed to perform a subgroup analysis because of the insufficient number of procedures [10] . In addition, since Vola et al first reported total thoracoscopic AVR in 2014, only a few centers have performed further studies on this procedure.…”

Section: Discussionmentioning

confidence: 92%

Early clinical outcomes of total thoracoscopic aortic valve replacement

Song

Jiang

Zhu

et al. 2021

Preprint

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Background: With the promotion of minimally invasive concepts and advances in total thoracoscopic valve surgery, total thoracoscopic aortic valve surgery has become a new option for patients with aortic valve lesions. However, due to its anatomical characteristics, poor surgical field exposure and limited operating space, only a few centers have performed further studies on this procedure. Methods: We evaluate the safety and advantages of total thoracoscopic aortic valve replacement compared to the upper mini-sternotomy AVR group and the conventional AVR group with important perioperative data as well as early postoperative outcomes. Results: All patients successfully underwent elective surgery, with no intraoperative conversion or death occurring. Patients in the total thoracoscopy group had significantly prolonged CPB and aortic clamping (AC) times compared to the other two groups. The average Postoperative chest drainage in the first 24 h of the total thoracoscopic group was significantly less than the other two groups. The mean VAS pain score in the total thoracoscopic group was significantly less than the other two groups. In addition, the total thoracoscopic group had a significantly decreased ICU stay as well as the total hospital stay. Although the length of mechanical ventilation between groups did not show statistically significant differences, mechanical ventilation in the total thoracoscopy group had a smaller relative number. Conclusions: Despite the need for improvement, total thoracoscopic aortic valve replacement is safe, and may improve clinical outcome

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Section: Discussionmentioning

confidence: 92%

Early clinical outcomes of total thoracoscopic aortic valve replacement

Song

Jiang

Zhu

et al. 2021

Preprint

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“…At discharge, in-hospital TTE showed mild paravalvular leakage in 1 patient. The median hospital stay was 5 [4,7] days. Pertinent postoperative outcomes are given in Table 3.…”

Section: Early Resultsmentioning

confidence: 99%

“…Despite the acceptable initial clinical results, this technique did not evolve as expected due to limited indications and longer clamping and cardiopulmonary bypass (CPB) times [6]. Since then, only several sporadic reports or small cohorts of endoscopic AVR have been reported [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

A totally endoscopic approach for aortic valve surgery

Yilmaz

Genechten

Claessens

et al. 2022

European Journal of Cardio-Thoracic Surgery

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OBJECTIVE A new approach for totally endoscopic aortic valve replacement is described. METHODS From October 2017 through December 2020, 266 consecutive patients underwent totally endoscopic aortic valve replacement. Reoperations and combinations were excluded. RESULTS A total of 266 patients with a median age of 72 [64, 79] years underwent totally endoscopic aortic valve replacement, of which 250 (93.98%) patients were indicated to undergo surgery because of aortic valve stenosis. The median follow-up index was 0.69 (0.30, 0.90). Major adverse cardiac and cerebrovascular events occurred in four (1.50%) patients within 30 days. Overall hospital mortality was 1.50%. Twenty additional deaths (7.52%) occurred during the three-year follow-up. An early thoracoscopic revision was needed in seven patients due to signs of bleeding or cardiac tamponade. Fourteen patients required permanent pacemaker implantation. CONCLUSIONS Retrospective analysis of our early experience with totally endoscopic aortic valve replacement in 266 consecutive patients demonstrated satisfactory results, with low mortality and acceptable morbidity rates.

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“…Regardless of the speed and duration of the procedure, the choice of prosthetic valve has a more robust association with patient selection. Cresce et al [ 20 ] reported the largest series of minimally invasive endoscopic AVR covering stented bioprostheses, rapid deployment valves, and sutureless valves. All types of valves are feasible.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of two-port thoracoscopic aortic valve replacement

Tan

Wei

Liu

et al. 2023

J Cardiothorac Surg

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Background Pure aortic valve disease is common and has been treated with sternotomy aortic valve replacement for decades. Minimally invasive cardiac surgery has been widely used in atrioventricular valve lesions, but totally thoracoscopic aortic valve replacement has rarely been reported. Method The profiles of 9 patients who were diagnosed with severe aortic valve diseases and treated with two-port thoracoscopic aortic valve replacement between February 2021 and February 2022 were retrospectively reviewed. The clinical data, including baseline characteristics, operative data, postoperative complications, and short-term outcomes, were reported. Results All nine patients successfully underwent two-port thoracoscopic aortic valve replacement, with a cardiopulmonary bypass time of 137.56 ± 27.99 min and an aortic cross-clamp time of 95.33 ± 17.96 min. Seven (77.78%) patients underwent mechanical valve replacement, and two (22.22%) patients underwent bioprosthetic valve replacement. Two (22.22%) patients underwent a concomitant aortic root enlargement procedure. There were no intraoperative or postoperative deaths. The incidence of procedural complications was 0%, while the results of ventilation time, intensive care unit stay length, blood transfusion, chest tube drainage, and kidney function were satisfactory. Conclusion Two-port thoracoscopic aortic valve replacement is a safe and effective surgical treatment option for carefully selected patients with pure aortic valve diseases.

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Minimally Invasive Endoscopic Aortic Valve Replacement: Operative Results

Cited by 16 publications

References 15 publications

Early clinical outcomes of total thoracoscopic aortic valve replacement

Early clinical outcomes of total thoracoscopic aortic valve replacement

A totally endoscopic approach for aortic valve surgery

Safety and efficacy of two-port thoracoscopic aortic valve replacement

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