Results of minimally invasive aortic valve replacement

Adam R. Kowalówka; Jakub Staromłyński; Konrad Mendrala; Mariusz Kowalewski; Ryszard Bachowski; Radoslaw Gocol

doi:10.5114/kitp.2025.158102

eISSN: 1897-4252
ISSN: 1731-5530

Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery

Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Contact Instructions for authors Publication charge Ethical standards and procedures

Editorial System

Submit your Manuscript

4/2025
vol. 22

Send email

Copy url:

abstract:

Original paper

Results of minimally invasive aortic valve replacement

Adam R. Kowalówka

¹

,

Jakub Staromłyński

²

,

Konrad Mendrala

³

,

Mariusz Kowalewski

^{2, 4}

,

Ryszard Bachowski

¹

,

Radoslaw Gocol

¹

Department of Cardiac Surgery, Medical University of Silesia, Faculty of Medical Sciences, Katowice, Poland
Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, Warsaw, Poland
Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland

Kardiochirurgia i Torakochirurgia Polska 2025; 22 (4): 258-266

DOI: https://doi.org/10.5114/kitp.2025.158102

Online publish date: 2025/12/30

View full text Get citation

PlumX metrics:

Introduction
Patients with severe aortic valve (AV) stenosis or insufficiency can undergo minimally invasive aortic valve surgery with mini-sternotomy (MS) or full sternotomy (FS).

Aim
Our study evaluated 5-year outcomes in patients after minimally invasive surgery for aortic valve replacement (AVR) compared with FS access.

Material and methods
We conducted a single-center registry data analysis of AV patients who underwent only elective, isolated AVR compared to MS, and FS hospitalized between 2014 and 2024 in the Cardiac Surgery Department at the Medical University of Silesia. Redo, emergency, salvage and concomitant procedures were excluded. The 5-year survival data were verified in the National Health Fund. Propensity score matching (PSM) was conducted to determine FS controls for the MS group in a 1 : 1 ratio with a 0.1 SD caliper.

Results
The study group included 1289 elective patients (73 MS, and 1216 FS). All operative and postoperative data before and after PSM are presented in tables. PSM resulted in 65 MS cases and 65 FS controls. The 5-year survival did not differ between groups, either before PSM (HR = 0.92, 95% CI [0.34–2.5]; p = 0.6) or after PSM (HR = 0.79, 95% CI [0.25–2.5]; p = 0.480). After matching, differences were found only in cardiopulmonary bypass time in MS vs. FS (73 [IQR: 61–88] vs. 63 [IQR: 53–77]; p = 0.034) and higher requirement for norepinephrine support (90.8% vs. 61.5%; p < 0.001).

Conclusions
Our study demonstrates that minimally invasive aortic valve replacement offers comparable 5-year outcomes. The results suggest that the less invasive alternative should be the first choice option for patients with aortic valve diseases.

keywords:

Results of minimally invasive aortic valve replacement

Adam R. Kowalówka 1 , Jakub Staromłyński 2 , Konrad Mendrala 3 , Mariusz Kowalewski 2, 4 , Ryszard Bachowski 1 , Radoslaw Gocol 1

aortic stenosis, aortic valve replacement, minimal invasive operations

Adam R. Kowalówka

¹

,

Jakub Staromłyński

²

,

Konrad Mendrala

³

,

Mariusz Kowalewski

^{2, 4}

,

Ryszard Bachowski

¹

,

Radoslaw Gocol

¹