Document Detail


Minimally invasive versus conventional aortic valve operations: a prospective study in 120 patients.
MedLine Citation:
PMID:  10320242     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Risk evaluation comparing the minimally invasive and standard aortic valve operations has not been studied. METHODS: Four surgeons were randomly assigned to perform the minimally invasive (L-shaped sternotomy) (group 1) or the conventional (group 2) operation in 120 patients exclusively. RESULTS: In both groups (n = 60) a CarboMedics prothesis was implanted in 90% of patients. There was no significant difference in the cross-clamping period (group 1, 60 minutes; range, 35 to 116 minutes), in the duration of extracorporal circulation (group 1, 84 minutes; range, 51 to 179 minutes) or in the time from skin-to-skin (group 1, 195 minutes; range, 145 to 466 minutes). Patients in group 1 were extubated earlier (p<0.001), the postoperative blood loss was less (p<0.001), and the need for analgesics was reduced (p<0.05). In 5 patients in group 1 a redo operation was required for bleeding (p>0.05), 3 patients in group 1 required a redo operation because of paravalvular leakage or endocarditis (p>0.05), the 30-day mortality rate was 1.6%. Overall the survival rate was 95% in group 1 and 97% in group 2 (mean follow-up, 294 days; range, 30 to 745 days). CONCLUSION: The advantages of minimally invasive aortic valve operation include reduced trauma from incision and duration of ventilation, decreased blood loss and postoperative pain, the avoidance of groin cannulation, and a cosmetically attractive result. Simple equipment is used with a high degree of effectiveness and with no sacrifice of safety. Our study demonstrated the practicability and reliability of this new method.
Authors:
H E Mächler; P Bergmann; M Anelli-Monti; D Dacar; P Rehak; I Knez; L Salaymeh; E Mahla; B Rigler
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  67     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-25     Completed Date:  1999-05-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1001-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Karl-Franzens University Graz, Austria. heinrich.maechler@kfunigraz.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Valve / surgery*
Extracorporeal Circulation
Female
Humans
Male
Middle Aged
Pain, Postoperative / prevention & control
Postoperative Complications
Postoperative Hemorrhage / prevention & control
Prospective Studies
Reoperation
Surgical Procedures, Minimally Invasive*
Survival Rate
Comments/Corrections
Comment In:
Ann Thorac Surg. 2000 Mar;69(3):977-8   [PMID:  10750816 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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