Magnus Dalén1, Fausto Biancari2, Antonino S Rubino3, Giuseppe Santarpino4, Natalie Glaser5, Herbert De Praetere6, Keiichiro Kasama6, Tatu Juvonen2, Wanda Deste3, Francesco Pollari4, Bart Meuris6, Theodor Fischlein4, Carmelo Mignosa3, Giuseppe Gatti7, Aniello Pappalardo7, Peter Svenarud5, Ulrik Sartipy5. 1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden magnus.dalen@karolinska.se. 2. Department of Surgery, Oulu University Hospital, Oulu, Finland. 3. Cardiac Surgery Unit, A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy. 4. Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany. 5. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden. 6. Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium. 7. Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
Abstract
OBJECTIVES: The aim of this study was to analyse early postoperative outcomes and 2-year survival after aortic valve replacement (AVR) through a ministernotomy with a sutureless bioprosthesis implantation compared with a full sternotomy with implantation of a stented bioprosthesis. METHODS: Patients who underwent primary isolated non-emergent AVR at six European centres were included in the study. Of these, 182 (32%) underwent a ministernotomy with a sutureless bioprosthesis (ministernotomy sutureless group) and 383 (68%) a full sternotomy with a stented bioprosthesis (full sternotomy stented group). Propensity score matching was used to reduce selection bias. RESULTS: In the overall cohort, 30-day mortality was 1.6 and 2.1%, and 2-year survival was 92 and 92% in the ministernotomy sutureless group and in the full sternotomy stented group, respectively. Propensity score matching resulted in 171 pairs with similar characteristics and operative risk. Aortic cross-clamp (40 vs 65 min, P < 0.001) and cardiopulmonary bypass time (69 vs 87 min, P < 0.001) were shorter in the ministernotomy sutureless group. Patients undergoing ministernotomy received less packed red blood cells but the risk for postoperative permanent pacemaker implantation was higher. There were no differences regarding 30-day mortality or 2-year survival between the two groups. CONCLUSIONS: AVR through a ministernotomy with implantation of a sutureless bioprosthesis was associated with shorter aortic cross-clamp and cardiopulmonary bypass time and less transfusion of packed red blood cells, but a higher risk for postoperative permanent pacemaker implantation compared with a full sternotomy with a stented bioprosthesis.
OBJECTIVES: The aim of this study was to analyse early postoperative outcomes and 2-year survival after aortic valve replacement (AVR) through a ministernotomy with a sutureless bioprosthesis implantation compared with a full sternotomy with implantation of a stented bioprosthesis. METHODS:Patients who underwent primary isolated non-emergent AVR at six European centres were included in the study. Of these, 182 (32%) underwent a ministernotomy with a sutureless bioprosthesis (ministernotomy sutureless group) and 383 (68%) a full sternotomy with a stented bioprosthesis (full sternotomy stented group). Propensity score matching was used to reduce selection bias. RESULTS: In the overall cohort, 30-day mortality was 1.6 and 2.1%, and 2-year survival was 92 and 92% in the ministernotomy sutureless group and in the full sternotomy stented group, respectively. Propensity score matching resulted in 171 pairs with similar characteristics and operative risk. Aortic cross-clamp (40 vs 65 min, P < 0.001) and cardiopulmonary bypass time (69 vs 87 min, P < 0.001) were shorter in the ministernotomy sutureless group. Patients undergoing ministernotomy received less packed red blood cells but the risk for postoperative permanent pacemaker implantation was higher. There were no differences regarding 30-day mortality or 2-year survival between the two groups. CONCLUSIONS: AVR through a ministernotomy with implantation of a sutureless bioprosthesis was associated with shorter aortic cross-clamp and cardiopulmonary bypass time and less transfusion of packed red blood cells, but a higher risk for postoperative permanent pacemaker implantation compared with a full sternotomy with a stented bioprosthesis.
Authors: Kei Woldendorp; Mathew P Doyle; Paul G Bannon; Martin Misfeld; Tristan D Yan; Giuseppe Santarpino; Paolo Berretta; Marco Di Eusanio; Bart Meuris; Alfredo Giuseppe Cerillo; Pierluigi Stefàno; Niccolò Marchionni; Jacqueline K Olive; Tom C Nguyen; Marco Solinas; Giacomo Bianchi Journal: Ann Cardiothorac Surg Date: 2020-09
Authors: Declan Lloyd; Jessica G Y Luc; Ben Elias Indja; Vannessa Leung; Nelson Wang; Kevin Phan Journal: J Thorac Dis Date: 2019-01 Impact factor: 2.895
Authors: Massimo Meco; Andrea Montisci; Antonio Miceli; Paolo Panisi; Francesco Donatelli; Silvia Cirri; Matteo Ferrarini; Antonio Lio; Mattia Glauber Journal: J Am Heart Assoc Date: 2018-02-16 Impact factor: 5.501