[Minimalinvaziv aortabillentyu-beultetes soran nyert kezdeti tapasztalataink].

Introduction

Due to the aging population, aortic valve stenosis is the most frequently diagnosed acquired cardiac disease amongst adults. Various surgical techniques have been developed and median sternotomy has become the standard practice for exploration. Improvements in cardiological intervention techniques allow surgery to provide the same quality with less invasiveness.

Objective

Our aim was to compare the results of the isolated aortic valve surgeries (AVR) performed as either full or partial sternotomy during the study period in terms of pre-, intra-, and postoperative variables.Patients and methods: We examined the results of the isolated AVR performed at Gottsegen National Cardiovascular Center between January 2019 and March 2020 (99 AVR and 151 mini-AVR). During mini-AVR we opened the sternum with J shape ministernotomy up to the 3rd or 4th intercostal space while in median sternotomy we separated the sternum in its total length.

Results

Blood consumption (unit) (AVR: 2.90 [2.90]; mini-AVR: 1.85 [2.12]; p<0,05), days of hospitalization (AVR: 9.75 [2.99]; mini-AVR: 8.85 [2.85]; p<0,05) and length of surgery (minutes) (AVR:148.49 [34.4]; mini-AVR: 134.6 [34.8]; p<0,05) were significantly better in the mini-AVR group. In terms of preoperative variables, the two groups were not homogeneous therefore we corrected the strong predictive variables. As a result, levels of bio-statistical significance have disappeared but there is still a trend in favour of minimally invasive surgery.

Conclusions

Mini-AVR surgery is considered a more cost-effective intervention compared to standard surgery in terms of less surgical trauma, reduced blood consumption, and shorter operative time.