Partial versus full sternotomy for aortic valve replacement

Szwerc, Michael F; Benckart, Daniel H.; Wiechmann, Robert J.; Savage, Edward B.; Szydlowski, Gary W; Magovern, George J.; Magovern, James A.

doi:10.1016/s0003-4975(99)00863-2

Cited by 65 publications

(50 citation statements)

References 12 publications

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“…This fact is rarely discussed in articles presented in the literature, but it was reported by Moustafa et al [46] comparing 0% versus 50% of inotropes used only in cases of conventional sternotomy. Szwerc et al [47] compared the partial and total sternotomy in aortic valve surgery and also observed a reduction in the use of inotropes in the alternative procedure.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive aortic valve replacement: an alternative to the conventional technique

Júnior

Fernandes

Sesca

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Section: Discussionmentioning

confidence: 99%

Minimally invasive aortic valve replacement: an alternative to the conventional technique

Júnior

Fernandes

Sesca

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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“…In an early paper, blind calls to patients 3 months postoperatively revealed significantly earlier recovery and return to work in the minimally invasive aortic valve group [2]. On the other hand, several studies have reported no particular benefit other than cosmesis [7][8][9][10]13]. However, these potential benefits On the other hand, limited exposure of the heart is a potential disadvantage of MIAVS Several studies have shown longer operation time compared to a full sternotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have shown that it can be done safely with mortality and morbidity similar to conventional full sternotomy aortic valve surgery [3][4][5][6][7][8][9][10][11][12][13][14][15]. Several studies have also shown that the minimal access approach contributes to better surgical outcomes compared to a full sternotomy [3][4][5][14][15][16] although it is still controversial.…”

Section: Introductionmentioning

confidence: 99%

Early and late outcomes of 1000 minimally invasive aortic valve operations☆

Tabata

Umakanthan

Cohn

et al. 2008

European Journal of Cardio-Thoracic Surgery

179

113

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Objective: Minimal access cardiac valve surgery is increasingly utilized. We report our 11-year experience with minimally invasive aortic valve surgery. Methods: From 07/96 to 12/06, 1005 patients underwent minimally invasive aortic valve surgery. Early and late outcomes were analyzed. Results: Median patient age was 68 years (range: 24-95), 179 patients (18%) were 80 years or older, 130 patients (13%) had reoperative aortic valve surgery, 86 (8.4%) had aortic root replacement, 62 (6.1%) had concomitant ascending aortic replacement, and 26 (2.6%) had percutaneous coronary intervention on the day of surgery (hybrid procedure). Operative mortality was 1.9% (19/1005). The incidences of deep sternal wound infection, pneumonia and reoperation for bleeding were 0.5% (5/1005), 1.3% (13/1005) and 2.4% (25/1005), respectively. Median length of stay was 6 days and 733 patients (72%) were discharged home. Actuarial survival was 91% at 5 years and 88% at 10 years. In the subgroup of the elderly (80 years), operative mortality was 1.7% (3/179), median length of stay was 8 days and 66 patients (37%) were discharged home. Actuarial survival at 5 years was 84%. There was a significant decreasing trend in cardiopulmonary bypass time, the incidence of bleeding, and operative mortality over time. Conclusions: Minimal access approaches in aortic valve surgery are safe and feasible with excellent outcomes. Aortic root replacement, ascending aortic replacement, and reoperative surgery can be performed with these approaches. These procedures are particularly well-tolerated in the elderly. #

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“…Early results of minimally invasive aortic valve surgery were promising in selected centers, with mortality rates of 0.8% to 4%, leading to increasing utilization of less invasive approaches for valve surgery throughout the world. [3][4][5][6][7][8][9] However, many surgeons remain skeptical about the advantages of this approach and require more data before adopting a less invasive technique. 10 Comparative studies of minimally invasive and conventional median sternotomy approaches for AVR demonstrated comparable early mortality.…”

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confidence: 99%

“…11,12 Although most studies have shown less need for transfusion and better postoperative pulmonary function after minimally invasive approaches, [13][14][15] there have been contradictory reports regarding earlier hospital discharge. 6,11,16 Increased operative risk has been reported for elderly patients undergoing aortic valve surgery, with operative mortality between 7.4 to 16.7%. [17][18][19] In the present study we assessed the hypothesis that in the elderly population, MIAVR is comparable to a standard sternotomy (SS) approach in terms of morbidity and mortality but results in a shorter and more facile hospital recovery.…”

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confidence: 99%