Aortic valve replacement through minimally invasive approach – initial experience

Objectives: Assessment of aortic valve replacement technology through minimally invasive approach, in terms of morbidity and mortality, the initial experience of a single center. Methods: There have been analyzed the data of 7 patients with aortic stenosis that required aortic valve replacement during January 2014 – June 2014, at the Emergency Institute of Cardiovascular Diseases “Prof. dr. C. C. Iliescu”. For all patients the etiology was degenerative valvular disease. The average age of the group was 65.71 years, with a sex ratio of 1.33 in favor of male. Aortic valve replacement was performed in all cases by partial median sternotomy with unilateral J-shaped extension to the right through the fourth intercostal space, using mechanical prosthesis in 3 of the cases and biological for the other ones. Mean EuroSCORE was 4, with 3 pathologies associated, on average (maximum 4 minimum 2). Results: The mean clamping time was 70.85 minutes, and the average CPR duration was 97.28 minutes. One patient developed postoperative complications, with slow favorable evolution postoperatively. Average drainage in the first 24 hours was 253.57 mL, with reduced transfusion requirements. All patients were extubated in the first 6 to 12 hours postoperatively. The mean stay in the ICU was 2.85 days and the mean duration of postoperative hospitalization was 7.28 days. There were no recorded cases of patient-prosthesis-mismatch (PPM) and the maximum trans-prosthesis pressure gradient postoperative was 15 + /- 5 mm Hg. Conclusions: Aortic valve replacement through a minimally invasive approach is an eff ective method of surgical treatment in the initial experience of our institute, reducing complication rates, duration and costs of hospitalization.

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