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Thorac Cardiovasc Surg 2017; 65(03): 191-197
DOI: 10.1055/s-0036-1587591
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Outcomes after Minimally Invasive Aortic Valve Surgery through Right Anterior Minithoracotomy

Diana Reser
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
,
Roman Walser
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
,
Mathias van Hemelrijk
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
,
Tomas Holubec
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
,
Alberto Weber
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
,
André Plass
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
,
Francesco Maisano
1   Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
› Author Affiliations
Further Information

Publication History

25 March 2016

13 July 2016

Publication Date:
30 August 2016 (online)

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Abstract

Background Minimally invasive aortic valve surgery (MIAV) through a right anterior minithoracotomy evolved to an accepted procedure with favorable short- and mid-term outcomes, whereas long-term results lack. The aim of this study was to evaluate the long-term outcomes.

Materials and Methods All our MIAV patients were included (n = 225). Mean age was 68 ± 12 years, 29% were older than 75 years, and median EuroSCORE was 5 (0–11). Baseline characteristics, inhospital outcomes, and follow-up information about survival, major adverse cardiac and cerebrovascular events (MACCE), and need for reoperation were collected and analyzed.

Results In this study, 30-day mortality was 1.3%, and there was no permanent stroke. Mean follow-up time was 69.65 ± 24 months, being the longest so far reported in the literature. At 1 and 7 years, survival was 95.8 and 79%, freedom from MACCE 98.1 and 95.7%, and from reoperation 99.5 and 98.7%, respectively.

Conclusion MIAV is safe and feasible with favorable long-term outcomes. In the future, it could serve as benchmark for interventional methods as soon as indications are expanded to young and low-risk patients. Randomized studies are needed to compare the long-term outcomes of these approaches.

Keywords

aortic valve replacement - minimally invasive - thoracotomy

Competing Interest

All authors declare that they have no competing financial or political interest.


 

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