Respiratory functional status after conventional and minimally invasive aortic valve replacement surgery – a propensity score analysis

Stoliński, Jarosław; Musiał, Robert; Plicner, Dariusz; Fijorek, Kamil; Mędrzycki, Michał; Andres, Janusz; Kapelak, Bogusław

doi:10.5114/kitp.2017.66922

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Six studies ( 5 , 6 , 14 – 16 , 35 ) reported on postoperative respiratory function tests based on spirometry, revealing that the overall complications were significantly reduced with MIVS compared to FS (964 vs. 964, WMD −24.83 95% CI [−29.90, −19.76]; p = <0.00001). Most pulmonary function tests showed that the MIVS group had better respiratory function than the FS group 1 week after surgery.…”

Section: Resultsmentioning

confidence: 99%

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

Mohamed

Ding

Shah

et al. 2021

Front. Cardiovasc. Med.

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Background: Postoperative pulmonary complications remain a leading cause of increased morbidity, mortality, longer hospital stays, and increased costs after cardiac surgery; therefore, our study aims to analyze whether minimally invasive valve surgery (MIVS) for both aortic and mitral valves can improve pulmonary function and reduce the incidence of postoperative pulmonary complications when compared with the full median sternotomy (FS) approach.Methods: A comprehensive systematic literature research was performed for studies comparing MIVS and FS up to February 2021. Randomized controlled trials (RCTs) and propensity score-matching (PSM) studies comparing early respiratory function and pulmonary complications after MIVS and FS were extracted and analyzed. Secondary outcomes included intra- and postoperative outcomes.Results: A total of 10,194 patients from 30 studies (6 RCTs and 24 PSM studies) were analyzed. Early mortality differed significantly between the groups (MIVS 1.2 vs. FS 1.9%; p = 0.005). Compared with FS, MIVS significantly lowered the incidence of postoperative pulmonary complications (odds ratio 0.79, 95% confidence interval [0.67, 0.93]; p = 0.004) and improved early postoperative respiratory function status (mean difference −24.83 [−29.90, −19.76]; p < 0.00001). Blood transfusion amount was significantly lower after MIVS (p < 0.02), whereas cardiopulmonary bypass time and aortic cross-clamp time were significantly longer after MIVS (p < 0.00001).Conclusions: Our study showed that minimally invasive valve surgery decreases the incidence of postoperative pulmonary complications and improves postoperative respiratory function status.

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Section: Resultsmentioning

confidence: 99%

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

Mohamed

Ding

Shah

et al. 2021

Front. Cardiovasc. Med.

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“…Our experience supports this, with only four patients requiring transfusion of pRBCs postoperatively and we believe sparing the sternum greatly contributes to this low incidence. The risk of renal and respiratory failure has also been found to be lower in RAMT AVR cohorts when compared to sternotomy approaches, both full and hemi‐sternotomy 50,55 . In our study, no patients experienced postoperative kidney injury that necessitated intervention (continuous renal replacement therapy or dialysis).…”

Section: Discussionsupporting

confidence: 50%

“…The risk of renal and respiratory failure has also been found to be lower in RAMT AVR cohorts when compared to sternotomy approaches, both full and hemi-sternotomy. 50,55 In our study, no patients experienced postoperative kidney injury that necessitated intervention (continuous renal replacement therapy or dialysis). Studies have also found RAMT AVR is associated with shorter ventilatory times.…”

Section: Postoperative Outcomesmentioning

confidence: 70%

Right anterior mini thoracotomy approach for isolated aortic valve replacement: Early outcomes at a Canadian center

Hassanabad

Aboelnazar

Maitland

et al. 2021

Journal of Cardiac Surgery

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Objective: The goal of this manuscript was to report the clinical outcomes of the initial series of 100 consecutive Right Anterior Mini Thoracotomy (RAMT) aortic valve replacement (AVR) implantations at a Canadian Center.Methods: This retrospective study reported the clinical outcomes of the first 100 patients who underwent the RAMT approach for isolated surgical AVR in Calgary, Canada, between 2016 and 2020. Primary outcomes were death within 30 days of surgery and disabling stroke. Secondary outcomes included surgical times, the need for permanent pacemaker (PPM), incidence of postoperative blood transfusion in the intensive care unit (ICU), postsurgical atrial fibrillation (AF), length of ICU/hospital stay, postsurgical AF, residual paravalvular leak (PVL), postoperative transvalvular gradient, need for postsurgical intravenous opioids, duration of invasive ventilation in the ICU, and chest tube output in the first 12 h postsurgery.Results: In this study, 54 patients were male, and the average age of the cohort was 72 years. Mortality within 30 days of surgery was 1% with no disabling postoperative strokes. Mean cardiopulmonary bypass and cross clamp was 84 and 55 min, respectively. PPM rate was 3%, incidence of blood transfusion in the ICU was 4%, and the rate of postoperative AF was 23%. Median length of ICU and hospital stay was 1 and 5 days, respectively. Rate of mild or greater residual PVL was 3%, while the average residual transvalvular mean gradient was 8.5 mmHg. Conclusion:The sternum-sparing RAMT approach can be safely integrated into surgical practice as a minimally invasive alternative for isolated AVR, and can reduce postoperative bleeding and narcotic requirements.

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“…Sternal integrity is crucial for faster respiratory recovery, early hospital discharge and physical functioning [15]. The physical functioning scale includes daily activity, including the ability to engage in vigorous activities such as running and weightlifting, to perform moderate activities or to carry groceries, to climb several flights of stairs, to walk several blocks, to bend, and to kneel, all of which are related to sternal stability.…”

Section: Discussionmentioning

confidence: 99%

Measurement of health-related quality of life post aortic valve replacement via minimally invasive incisions

Jawad

Mourad

2022

J Cardiothorac Surg

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Background Minimally invasive aortic surgery is growing in popularity among surgeons. Although many clinical reports have proven both the safety and efficacy from a surgical point of view, there are few data regarding its impact on patients’ quality of life and whether there is a difference between ministernotomy and minithoracotomy from the patient perspective. Methods This prospective, questionnaire-based, nonrandomized study included 189 patients who underwent aortic valve replacement via a minimally invasive incision between May 2014 and December 2020 and completed at least 1 year of follow-up. The study uses the RAND SF 36-Item Health Survey 1.0 to assess and compare health-related quality of life between ministernotomy and minithoracotomy. Results There was a statistically significant improvement in the minithoracotomy group with regard to physical functioning, role limitation due to a physical problem, and social functioning (79.69 ± 20.72, 75.28 ± 26.52, 87.91 ± 16.98) compared to the ministernotomy group (70.31 ± 22.88, 58.59 ± 31.17, 66.15 ± 27.32) with p values (0.0036, 0.0001, < 0.0001), respectively. Conclusions Both minimally invasive aortic valve incisions positively impacted patient quality of life. The minithoracotomy incision showed significant improvements in physical capacity and successful patient re-engagement in daily physical and social activities. This, in turn, positively improved their general health status compared to the 1-year preoperative status. Trial registration: This study was approved by the Research Ethics Committee (REC) at the Faculty of Medicine, Ain Shams University, under the number code (FWA 000017585, FAMSU R 91 /2021).

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Respiratory functional status after conventional and minimally invasive aortic valve replacement surgery – a propensity score analysis

Cited by 3 publications

References 10 publications

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

Right anterior mini thoracotomy approach for isolated aortic valve replacement: Early outcomes at a Canadian center

Measurement of health-related quality of life post aortic valve replacement via minimally invasive incisions

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