Low-Risk Surgical Aortic Valve Replacement in the Era of Transcatheter Aortic Valve Implantation
© 2022 by the Texas Heart® Institute, Houston..
Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantation in low-risk patients. In this light, we evaluated the safety and effectiveness of SAVR performed through conventional and less invasive surgical approaches in a high-volume center. We retrospectively reviewed the records of 395 consecutive patients who underwent open SAVR from January 2019 through December 2019 in our center. We evaluated and compared the operative results and postoperative major adverse outcomes of 3 surgical approaches: full median sternotomy (n=267), upper ministernotomy (ministernotomy) (n=106), and right anterior thoracotomy (minithoracotomy) (n=22). Overall, the 30-day all-cause mortality rate was 0.8% (3 patients). Stroke occurred in 8 patients (2%), disabling stroke in 4 patients (1%), myocardial infarction in 1 (0.2%), and surgical site infection in 13 (3.2%). There was no difference in 30-day mortality rate or incidence of postoperative major adverse events among the 3 surgical groups. Stroke and surgical site infection occurred more frequently, but not significantly so, in the full-sternotomy group. The mean hospital stay was longer after full sternotomy (9.1 ± 5.5 d) than after ministernotomy (7.5 ± 2.9 d) or minithoracotomy (7.4 ± 1.9 d) (P=0.012). Our findings suggest that open SAVR performed in a high-volume center is associated with a low early mortality rate and that less invasive approaches result in faster postoperative recovery and shorter hospital stays.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
|---|---|
| Enthalten in: |
Texas Heart Institute journal - 49(2022), 1 vom: 01. Jan. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Jovanovic, Milos M [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 25.04.2022 Date Revised 25.04.2022 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.14503/THIJ-20-7435 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM336333013 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM336333013 | ||
| 003 | DE-627 | ||
| 005 | 20231225231915.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.14503/THIJ-20-7435 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1121.xml |
| 035 | |a (DE-627)NLM336333013 | ||
| 035 | |a (NLM)35099560 | ||
| 035 | |a (PII)e207435 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Jovanovic, Milos M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Low-Risk Surgical Aortic Valve Replacement in the Era of Transcatheter Aortic Valve Implantation |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.04.2022 | ||
| 500 | |a Date Revised 25.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 by the Texas Heart® Institute, Houston. | ||
| 520 | |a Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantation in low-risk patients. In this light, we evaluated the safety and effectiveness of SAVR performed through conventional and less invasive surgical approaches in a high-volume center. We retrospectively reviewed the records of 395 consecutive patients who underwent open SAVR from January 2019 through December 2019 in our center. We evaluated and compared the operative results and postoperative major adverse outcomes of 3 surgical approaches: full median sternotomy (n=267), upper ministernotomy (ministernotomy) (n=106), and right anterior thoracotomy (minithoracotomy) (n=22). Overall, the 30-day all-cause mortality rate was 0.8% (3 patients). Stroke occurred in 8 patients (2%), disabling stroke in 4 patients (1%), myocardial infarction in 1 (0.2%), and surgical site infection in 13 (3.2%). There was no difference in 30-day mortality rate or incidence of postoperative major adverse events among the 3 surgical groups. Stroke and surgical site infection occurred more frequently, but not significantly so, in the full-sternotomy group. The mean hospital stay was longer after full sternotomy (9.1 ± 5.5 d) than after ministernotomy (7.5 ± 2.9 d) or minithoracotomy (7.4 ± 1.9 d) (P=0.012). Our findings suggest that open SAVR performed in a high-volume center is associated with a low early mortality rate and that less invasive approaches result in faster postoperative recovery and shorter hospital stays | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aortic valve stenosis/surgery | |
| 650 | 4 | |a heart valve prosthesis implantation | |
| 650 | 4 | |a minimally invasive surgical procedures | |
| 650 | 4 | |a sternotomy | |
| 650 | 4 | |a sutureless surgical procedures | |
| 650 | 4 | |a thoracotomy | |
| 650 | 4 | |a transcatheter aortic valve replacement | |
| 650 | 4 | |a treatment outcome | |
| 700 | 1 | |a Micovic, Slobodan V |e verfasserin |4 aut | |
| 700 | 1 | |a Peric, Miodrag S |e verfasserin |4 aut | |
| 700 | 1 | |a Zivkovic, Igor S |e verfasserin |4 aut | |
| 700 | 1 | |a Krasic, Stasa D |e verfasserin |4 aut | |
| 700 | 1 | |a Milicevic, Ognjen S |e verfasserin |4 aut | |
| 700 | 1 | |a Stankovic, Stefan P |e verfasserin |4 aut | |
| 700 | 1 | |a Vukovic, Petar M |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Texas Heart Institute journal |d 1982 |g 49(2022), 1 vom: 01. Jan. |w (DE-627)NLM074901362 |x 1526-6702 |7 nnns |
| 773 | 1 | 8 | |g volume:49 |g year:2022 |g number:1 |g day:01 |g month:01 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.14503/THIJ-20-7435 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 49 |j 2022 |e 1 |b 01 |c 01 | ||