BACKGROUND: In recent years, minimally invasive cardiac surgery has been developed. Thus far, only at our institute has port-access aortic valve replacement (PAVR) been performed in Japan. Herein we review our experiences with PAVR, and evaluate the surgical outcomes. METHODS AND RESULTS: Between May, 2007 and June, 2010, 37 cases of PAVR were performed. During the same period, 107 patients underwent conventional aortic valve replacement (CAVR) with midline sternotomy. Because we initially selected patients without high risk factors for PAVR, there were some differences in the preoperative demographic data between the CAVR and PAVR groups. Although cardiopulmonary bypass time and cross-clamp time were longer in the PAVR group (139 ± 28 vs. 113 ± 34 min; 97 ± 23 vs. 83 ± 24min), there were no significant differences in total operative time between both groups. With regard to the percentage of blood transfusion requirement, postoperative ventilation time, intensive care unit stay and hospital stay the PAVR group had significantly lower outcomes (11 vs. 90; 3.4 ± 1.9 h vs. 8.2 ± 16.3 h; 1.2 ± 0.6 days vs. 2.5 ± 1.7 days; 11.1 ± 4.3 days vs. 19.7 ± 7.8 days, respectively). There were no significant differences in mortality (1/37), and morbidity between both groups. CONCLUSIONS: PAVR a feasible treatment of choice for patients with aortic valve diseases complicated by various preoperative backgrounds.
BACKGROUND: In recent years, minimally invasive cardiac surgery has been developed. Thus far, only at our institute has port-access aortic valve replacement (PAVR) been performed in Japan. Herein we review our experiences with PAVR, and evaluate the surgical outcomes. METHODS AND RESULTS: Between May, 2007 and June, 2010, 37 cases of PAVR were performed. During the same period, 107 patients underwent conventional aortic valve replacement (CAVR) with midline sternotomy. Because we initially selected patients without high risk factors for PAVR, there were some differences in the preoperative demographic data between the CAVR and PAVR groups. Although cardiopulmonary bypass time and cross-clamp time were longer in the PAVR group (139 ± 28 vs. 113 ± 34 min; 97 ± 23 vs. 83 ± 24min), there were no significant differences in total operative time between both groups. With regard to the percentage of blood transfusion requirement, postoperative ventilation time, intensive care unit stay and hospital stay the PAVR group had significantly lower outcomes (11 vs. 90; 3.4 ± 1.9 h vs. 8.2 ± 16.3 h; 1.2 ± 0.6 days vs. 2.5 ± 1.7 days; 11.1 ± 4.3 days vs. 19.7 ± 7.8 days, respectively). There were no significant differences in mortality (1/37), and morbidity between both groups. CONCLUSIONS: PAVR a feasible treatment of choice for patients with aortic valve diseases complicated by various preoperative backgrounds.
Authors: Michael E Bowdish; Dawn S Hui; John D Cleveland; Wendy J Mack; Raina Sinha; Rupesh Ranjan; Robbin G Cohen; Craig J Baker; Mark J Cunningham; Mark L Barr; Vaughn A Starnes Journal: Eur J Cardiothorac Surg Date: 2015-03-06 Impact factor: 4.191