Results of minimally invasive aortic valve replacement surgery through right thoracotomy at Hanoi Heart Hospital
Main Article Content
Abstract
Objectives: To evaluate results of minimally invasive aortic valve replacement surgery through right thoracotomy with some techinque improvements in Hanoi Heart Hospital.
Methods: Surgery was performed via a small right thoracotomy in the second intercostal space. The third rib was detached by a wedge-shaped way using sternum saw. Cannulation approaches were central or peripheral depended on patients’ condition. Preoperative, perioperative, early results and follow-up data was collected and analysed.
Results: There was 48 patients in the research. Mean age was 60,94 ± 11,53 (25-82), and 52,1% was male. 29,2% of patients had peripheral vascular disease. 22,9% underwent central arterial cannulation. 3 patients (6,3%) had pericardial adhesion. There was no early mortality, 2 patients had redo surgery due to excess bleeding. 1 patients had intestinal infarction. Mean follow-up time was 13,4 months. 91,3% of patients had NYHA I. 1 patients was dead due to intracerebral hemorrhage.
Conclusions: With some improvements in techniques, minimally invasive aortic valve replacement surgery through right thoracotomy gave good early and midterm results in our center.
Article Details
Keywords
minimally invasive, aorticvalve replacement, right thoracotomy, wedge-shaped
References
2. Ghanta, R.K., et al., Minimally invasive aortic valve replacement provides equivalent outcomes at reduced cost compared with conventional aortic valve replacement: A real-world multi-institutional analysis. J Thorac Cardiovasc Surg, 2015. 149(4): p. 1060-5.
3. Klein, P., et al., Planning for minimally invasive aortic valve replacement: key steps for patient assessment. Eur J Cardiothorac Surg, 2018. 53(suppl_2): p. ii3-ii8.
4. Tamagnini, G., R. Biondi, and M.D. Giglio, Aortic Valve Replacement Via Right Anterior Mini-Thoracotomy: the Conventional Procedure Performed Through a Smaller Incision. Braz J Cardiovasc Surg, 2021. 36(1): p. 120-124.
5. Bethencourt, D.M., et al., Minimally Invasive Aortic Valve Replacement via Right Anterior Minithoracotomy and Central Aortic Cannulation: A 13-Year Experience. Innovations (Phila), 2017. 12(2): p. 87-94.
6. Ribeiro, I.B. and M. Ruel, Right Anterior Minithoracotomy for Aortic Valve Replacement: A Widely Applicable, Simple, and Stepwise Approach. Innovations (Phila), 2019. 14(4): p. 321-329.
7. Seitz, M., et al., Minimally Invasive Aortic Valve Replacement Via Right Anterior Mini-Thoracotomy: Propensity Matched Initial Experience. Heart Lung Circ, 2019. 28(2): p. 320-326.
8. Mikus, E., et al., Aortic valve replacement through right minithoracotomy: is it really biologically minimally invasive? Ann Thorac Surg, 2015. 99(3): p. 826-30.
9. Robinson, D.A., et al., Concomitant Annular Enlargement in Minimally Invasive Aortic Valve Replacement. Innovations (Phila), 2019. 14(2): p. 159-167.
10. Bowdish, M.E., et al., A comparison of aortic valve replacement via an anterior right minithoracotomy with standard sternotomy: a propensity score analysis of 492 patients. Eur J Cardiothorac Surg, 2016. 49(2): p. 456-63.
11. Miceli, A., et al., Minimally invasive aortic valve replacement using right minithoracotomy is associated with better outcomes than ministernotomy. J Thorac Cardiovasc Surg, 2014. 148(1): p. 133-7.
12. Fattouch, K., et al., Non-sutureless minimally invasive aortic valve replacement: mini-sternotomy versus mini-thoracotomy: a series of 1130 patients. Interact Cardiovasc Thorac Surg, 2016. 23(2): p. 253-8.
13. Olds, A., et al., Improved operative and recovery times with mini-thoracotomy aortic valve replacement. J Cardiothorac Surg, 2019. 14(1): p. 91.
14. Salenger, R., J.S. Gammie, and J.A. Collins, Minimally Invasive Aortic Valve Replacement. J Card Surg, 2016. 31(1): p. 38-50.
15. Sayed, A., et al., Minimally invasive surgery versus transcatheter aortic valve replacement: a systematic review and meta-analysis. Open Heart, 2021. 8(1).