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Research Article
Minimally invasive approach in aortic valve replacement: Techniques, patient’s selection, and early post-operative outcomes
1 Cardiovascular Surgery Department, Mohammed VI University Hospital, Marrakech, Morocco
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Issaka Zallé
CHU Mohammed VI, BP 2360, Avenue Ibn Sina, Marrakech, MA 40080,
Morocco
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Article ID: 100020C04IZ2021
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How to cite this article
Zallé I, Son M, Nijimbere M, Boumzebra D. Minimally invasive approach in aortic valve replacement: Techniques, patient’s selection, and early postoperative outcomes. Edorium J Cardiothorac Vasc Surg 2021;8:100020C04IZ2021.ABSTRACT
Aims: In our department, heart valves surgery is routinely performed with conventional full sternotomy. This study aims to report our experience in minimally invasive technique with reference to patient selection, surgical techniques, and early post-operative outcomes.
Methods: Eighteen (18) patients undergoing aortic valve surgery for isolated aortic valve disease were analyzed prospectively from November 2017 to October 2019 in our institution. All patients underwent isolated aortic valve replacement.
Results: The mean age of the patients was 48.4 [28–69] years and 76.4% were male; mean weight was 63.8 [56–82] kg. The average New York Heart Association (NYHA) was 2.4 [1–3]. There were 3 cases of mellitus diabetes, 2 cases of arterial hypertension. Heart function was good in all patients (left ventricular ejection fraction, LVEF 58.3% [35–73]). Pre-operative hemoglobin was 13.9 [10.9–15.3] g/dL [15.7] g/dL. Right anterior mini-thoracotomy with femoro-femoral cannulation for cardiopulmonary bypass (CPB) and upper mini-sternotomy (UMS) were our surgical approaches. There was no conversion to full sternotomy. The mean CPB time and aortic cross-clamp (ACC) time were respectively 131 and 81 minutes, 16.7% of patients required intra and post-operative red blood cells transfusion, post-operative hemoglobin was 11.78 [7.3–14.4] g/dL and 16.7% had needed inotropic support. Mean ventilation time was 2.35 [1–12] hours, and mean time of intensive care unit (ICU) stay was 2.44 [1–8] days; length of hospital stay at 6.5 [5–10] days. The length of chest drains stay was 1.53 [1–2] days. One (1) patient developed cerebrovascular event; there was no in-hospital and 30-days mortality and no wound infections.
Conclusion: Minimally invasive aortic valve replacement (MIAVR) can be adopted as a new surgical approach for aortic valve replacement. Both the surgical access don’t compromise operative outcomes. Otherwise comparative study with conventional full sternotomy is necessary in order to establish the interest of MIAVR.
Keywords: Aortic valve replacement, Early outcomes, Minimally invasive
SUPPORTING INFORMATION
Author Contributions
Issaka Zallé - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Moussa Son - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Macedoine Nijimbere - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Drissi Boumzebra - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Issaka Zallé et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
