Jure Jug1, Zdravko Štor2, Borut Geršak1,3. 1. Faculty of Medicine, Chair of Surgery, University of Ljubljana, Ljubljana, Slovenia. 2. Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia. 3. Nisteri, Medicine and Research, Ljubljana, Slovenia.
Abstract
OBJECTIVES: Prolonged operative times, potentially leading to increased morbidity, are a possible drawback of minimally invasive aortic valve replacement. The aim of this study was to assess the impact of anatomical circumstances in the chest on aortic cross-clamp time. METHODS: This retrospective study included 68 patients who underwent minimally invasive aortic valve replacement with the Perceval sutureless valve via right-anterior thoracotomy or with ministernotomy. Anatomical variables were measured during preoperative computer tomography scans. RESULTS: Aortic cross-clamp time was shorter in those having ministernotomy than in the right-anterior thoracotomy group (41.1 vs 52.3 min; P < 0.001). Cardiopulmonary bypass (CPB) time was not significantly different between groups (P = 0.09). A multivariable linear-regression model (P = 0.018) showed the aortic dextroposition variable to be a significant predictor of the aortic cross-clamp method and CPB times (P = 0.005 and P = 0.003) independent of other anatomical variables in the right thoracotomy group (10 mm deviation from optimal position prolonged the times for 240 and 600 s). For the whole cohort, a correlation between aortic valve dimensions and operative times was found (P = 0.046, P = 0.009). A linear-regression model (P = 0.046) predicted 90 s longer aortic cross-clamp time and 231 s longer CPB time for every 1 mm smaller aortic valve diameter. CONCLUSIONS: The anatomical variables are associated with the operative times in minimally invasive aortic valve replacement with sutureless valves. Considering this association, preplanning the procedure is recommended.
OBJECTIVES: Prolonged operative times, potentially leading to increased morbidity, are a possible drawback of minimally invasive aortic valve replacement. The aim of this study was to assess the impact of anatomical circumstances in the chest on aortic cross-clamp time. METHODS: This retrospective study included 68 patients who underwent minimally invasive aortic valve replacement with the Perceval sutureless valve via right-anterior thoracotomy or with ministernotomy. Anatomical variables were measured during preoperative computer tomography scans. RESULTS: Aortic cross-clamp time was shorter in those having ministernotomy than in the right-anterior thoracotomy group (41.1 vs 52.3 min; P < 0.001). Cardiopulmonary bypass (CPB) time was not significantly different between groups (P = 0.09). A multivariable linear-regression model (P = 0.018) showed the aortic dextroposition variable to be a significant predictor of the aortic cross-clamp method and CPB times (P = 0.005 and P = 0.003) independent of other anatomical variables in the right thoracotomy group (10 mm deviation from optimal position prolonged the times for 240 and 600 s). For the whole cohort, a correlation between aortic valve dimensions and operative times was found (P = 0.046, P = 0.009). A linear-regression model (P = 0.046) predicted 90 s longer aortic cross-clamp time and 231 s longer CPB time for every 1 mm smaller aortic valve diameter. CONCLUSIONS: The anatomical variables are associated with the operative times in minimally invasive aortic valve replacement with sutureless valves. Considering this association, preplanning the procedure is recommended.
Authors: Orlando Santana; Javier Reyna; Robert Grana; Mauricio Buendia; Gervasio A Lamas; Joseph Lamelas Journal: Ann Thorac Surg Date: 2011-02 Impact factor: 4.330
Authors: Nobuyuki Furukawa; Oliver Kuss; Anas Aboud; Michael Schönbrodt; Andre Renner; Kavous Hakim Meibodi; Tobias Becker; Amin Zittermann; Jan F Gummert; Jochen Börgermann Journal: Eur J Cardiothorac Surg Date: 2014-01-20 Impact factor: 4.191
Authors: Domenico Paparella; Pietro Giorgio Malvindi; Giuseppe Santarpino; Marco Moscarelli; Piero Guida; Khalil Fattouch; Vito Margari; Luigi Martinelli; Alberto Albertini; Giuseppe Speziale Journal: Eur J Cardiothorac Surg Date: 2020-04-01 Impact factor: 4.191
Authors: Bruce R Boti; Vikash G Hindori; Emilio L Schade; Athina M Kougioumtzoglou; Eva C Verbeek; Annet Driessen-Waaijer; Riccardo Cocchieri; Bas A J M de Mol; Nils R Planken; Abdullah Kaya; Henk A Marquering Journal: J Cardiothorac Surg Date: 2019-10-12 Impact factor: 1.637