Document Detail

Minimal access surgery of ascending and proximal arch of the aorta: a 9-year experience.
MedLine Citation:
PMID:  17588385     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Minimal access approaches are becoming readily accepted techniques for cardiac valve surgery. However, the safety or benefit of this approach for aortic surgery has not been well investigated. METHODS: We retrospectively analyzed 128 consecutive patients who underwent ascending aortic replacement (n = 53), proximal aortic arch replacement (n = 7), aortic root replacement (n = 67), or sinus of Valsalva aneurysm repair (n = 1) through an upper hemisternotomy between August 1996 and May 2005. Using matched variables (age, type of procedure, redo operation, and use of circulatory arrest), we constructed two matched cohorts of 79 patients each: a minimally invasive (group A) and full sternotomy (group B) and compared outcomes. RESULTS: The mean age for the minimally invasive group (n = 128) was 54 years (range, 25 to 83 years). There were six reoperations (4.7%), five (3.9%) urgent operations, and 16 (12.5%) deep hypothermic circulatory arrests. Operative mortality was zero, the median length of hospital stay was 5 days (range, 3 to 21 days), and 112 patients (82.4%) were discharged home. Actuarial survival at 5 years was 97.2%. On comparison between group A and B, there was no significant difference in operative times, mortality, and morbidity. However, group A had shorter median length of stay (5 versus 6 days, p = 0.020) and fewer median units of red blood cell transfusion than group B (2 versus 2.5, p = 0.020). CONCLUSIONS: An upper hemisternotomy approach is safe and feasible for ascending aortic and proximal arch surgical procedures, with excellent early and late outcomes. This approach is associated with shorter hospital stay and less blood transfusion.
Minoru Tabata; Zain Khalpey; Sary F Aranki; Gregory S Couper; Lawrence H Cohn; Prem S Shekar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  84     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  67-72     Citation Subset:  AIM; IM    
Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02446, USA.
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MeSH Terms
Aged, 80 and over
Aorta / surgery*
Aorta, Thoracic / surgery*
Cardiopulmonary Bypass
Erythrocyte Transfusion
Length of Stay
Middle Aged
Retrospective Studies
Sternum / surgery
Surgical Procedures, Minimally Invasive
Vascular Surgical Procedures
Comment In:
Ann Thorac Surg. 2007 Jul;84(1):72   [PMID:  17588386 ]

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