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Upper reversed-T mini-sternotomy for sutureless aortic valve replacement: an alternative for high-risk patients

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Názov: Upper reversed-T mini-sternotomy for sutureless aortic valve replacement: an alternative for high-risk patients
Autori: Mustafa Ozgur, Hakan Hancer, Baris Gurel, Ozge Altas, Halil Bulut, Tolga Bas, Sabit Sarikaya, Kaan Kırali
Prispievatelia: İstanbul University Cerrahpaşa Institutional Repository
Zdroj: Cardiovascular Journal of Africa. 36:196-201
Informácie o vydavateľovi: Clinics Cardive Publishing, 2025.
Rok vydania: 2025
Predmety: Diagnostic Imaging, Male, Very Elderly, Time Factors, Etiology, Time Factor, Aortic Valve, Calcification Of, Procedures, Prosthesis Design, Pathophysiology, Risk Assessment, Postoperative Complications, Sutureless Technique, Retrospective Study, Risk Factors, Devices, Pathology, Humans, Comparative Study, Mortality, Sutureless Valve, Mini‐sternotomy, Aged, Retrospective Studies, Heart Valve Prosthesis Implantation, Adverse Event, Risk Factor, Calcinosis, Aortic Valve Stenosis, Middle Aged, Aged, 80 And Over, Heart Valve Replacement, Sternotomy, Sutureless Surgical Procedures, Severity Of Illness Index, Treatment Outcome, Aortic Valve, Heart Valve Prosthesis, Female, Surgery, Postoperative Complication, Therapy, Aortic Valve Replacement, Human
Popis: BACKGROUND: Sutureless aortic prostheses are designed to make aortic valve replacement easier than stented or stentless prostheses in patients with significant aortic stenosis. Recently, a more minimally invasive approach combining sutureless aortic valve replacement with small incisions has emerged, but concerns remain about reduced surgical visibility and the risk of permanent pacemaker implantation. METHODS: Between 2015 and 2023, 216 patients underwent sutureless aortic valve replacement; of these, only 124 patients who underwent isolated primary aortic valve replacement surgery for severe calcific aortic valve stenosis were included in this study to compare in-hospital outcomes between the upper reversed-T mini-sternotomy and full sternotomy approaches. RESULTS: The mean age was 73.3 ± 7.1 years for full sternotomy [NK2] and 71.9 ± 5.7 years for mini sternotomy. The differences in preoperative risk factors, including associated cardiac pathologies, left ventricular functions, aortic valve pathologies, and aortic root status, were not significant. The mean aortic cross-clamp and associated total cardiopulmonary bypass times were higher in the mini-sternotomy group without any worsening of perioperative outcomes. Postoperative early complications were similar between the two groups, except for tube drainage and hospital stay, which were worse in the full sternotomy group. CONCLUSIONS: In elderly patients with severe calcific aortic stenosis, sutureless aortic valve replacement via the upper reversed-T mini-sternotomy approach is at least as successful as the full sternotomy method and can be preferred in this patient group due to advantages such as less drainage and faster recovery. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
Druh dokumentu: Article
ISSN: 1680-0745
1995-1892
DOI: 10.5830/cvja-2025-022
Prístupové číslo: edsair.doi.dedup.....a9f632a403deaf10d2bc3179bd315971
Databáza: OpenAIRE
Popis
Abstrakt:BACKGROUND: Sutureless aortic prostheses are designed to make aortic valve replacement easier than stented or stentless prostheses in patients with significant aortic stenosis. Recently, a more minimally invasive approach combining sutureless aortic valve replacement with small incisions has emerged, but concerns remain about reduced surgical visibility and the risk of permanent pacemaker implantation. METHODS: Between 2015 and 2023, 216 patients underwent sutureless aortic valve replacement; of these, only 124 patients who underwent isolated primary aortic valve replacement surgery for severe calcific aortic valve stenosis were included in this study to compare in-hospital outcomes between the upper reversed-T mini-sternotomy and full sternotomy approaches. RESULTS: The mean age was 73.3 ± 7.1 years for full sternotomy [NK2] and 71.9 ± 5.7 years for mini sternotomy. The differences in preoperative risk factors, including associated cardiac pathologies, left ventricular functions, aortic valve pathologies, and aortic root status, were not significant. The mean aortic cross-clamp and associated total cardiopulmonary bypass times were higher in the mini-sternotomy group without any worsening of perioperative outcomes. Postoperative early complications were similar between the two groups, except for tube drainage and hospital stay, which were worse in the full sternotomy group. CONCLUSIONS: In elderly patients with severe calcific aortic stenosis, sutureless aortic valve replacement via the upper reversed-T mini-sternotomy approach is at least as successful as the full sternotomy method and can be preferred in this patient group due to advantages such as less drainage and faster recovery. This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
ISSN:16800745
19951892
DOI:10.5830/cvja-2025-022