eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2023
vol. 20
 
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abstract:
Original paper

A comparative study of minimally invasive aortic valve replacement with sutureless biological versus mechanical prostheses

Michał Bociański
1
,
Mateusz Puślecki
1, 2
,
Anna Olasińska-Wiśniewska
1
,
Bartłomiej Perek
1
,
Sebastian Stefaniak
1
,
Piotr Buczkowski
1
,
Marek Jemielity
1

  1. Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Medical Rescue, Chair of Rescue Medicine, Poznan University of Medical Sciences, Poznan, Poland
Kardiochirurgia i Torakochirurgia Polska 2023; 20 (2): 77-82
DOI: https://doi.org/10.5114/kitp.2023.129542
Online publish date: 2023/07/26
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Introduction:
The ministernotomy approach with sutureless aortic bioprosthesis may provide an attractive and safe option for aortic valve disease patients.

Aim:
To assess the early and mid-term outcomes of minimally invasive aortic valve replacement (miniAVR) with sutureless vs. standard prostheses.

Material and methods:
The study involved 76 consecutive patients (51 males and 25 females) with mean age of 63.2 years who were treated with miniAVR between 2015 and 2022. They were divided into 2 subgroups: group I (n = 40) subjects with sutureless bioprostheses and group II (n = 36) with standard prostheses implanted. Early and mid-term outcomes were evaluated. A probability of survival was estimated by means of the Kaplan-Meier method

Results:
No conversion to complete sternotomy was necessary. The median (minimum; maximum) aorta cross clamping and cardio-pulmonary bypass times were 49 (27; 84) and 70 (40; 188) minutes in group I whereas 69 (50; 103) and 95 (69; 170) minutes in group II, respectively (p < 0.001). In-hospital mortality was 5.0% (n = 2) and 2.8% (n = 1) in group I vs. II, respectively (ns). Permanent ICD implantation was performed in 8 (20.0%) in group I and in 3 (8.3%) subjects in group II. In the discharge echocardiography, the function of all prostheses was correct. Five-year probability of survival was much lower in group I (0.75 ±0.10) than in group II (0.94 ±0.04). No wound infection or sternum instability was noted.

Conclusions:
Intraoperative advantages of miniAVR procedures for aortic valve patients with sutureless bioprostheses do not translate directly into improved early and middle-term outcomes.

keywords:

aortic valve disease, sutureless aortic prosthesis, ministernotomy, outcomes
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