Comparison of early postoperative quality of life in minimally invasive versus conventional valve surgery

Abstract

Although longer aortic clamp and cardiopulmonary bypass times remain a problem in MICS procedures, our results suggest that MICS, as compared with CCS, facilitates earlier recovery of daily activities and provides improved quality of life in the early postoperative period.

Aortic Valve Surgery: Minimally Invasive Options

“…Less pain and analgesic requirements is almost uniform in all studies that reported pain scoring. 1,6 Casselman et al reported 94% of their patients undergoing MIMVS as having no or mild postoperative pain and 99.3% as being esthetically pleased with their scar. 27 One concern with MIVS is a questionable association with stroke.…”

“…[1][2][3][4][5][6][7][8][9] However, its penetration into the cardiac surgical community has been less than optimal due to multiple issues, including required surgeon training and the inaccurate perception that transcatheter aortic valve replacement (TAVR) will eventually minimize the need for such techniques.…”

Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study

“…In these smaller randomized trials, adverse cardiac and cerebrovascular events as well as operative mortality were found to be comparable between the RT and MS groups [17][18][19]. In unmatched studies, RT also had advantages of earlier return to normal activity [20], less reoperation for bleeding [6], decreased pain [3], but increased risk of aortic dissection [5], while other unmatched studies found little effect of the RT approach on outcomes [21,22].…”

“…Given study limitations, the RT approach for mitral valve surgery may have advantages over median sternotomy in selected patients. A right minithoracotomy (RT) approach to mitral valve surgery has been associated with potential advantages relative to conventional median sternotomy (MS), including less blood loss and transfusion, earlier hospital discharge and recovery, less mediastinitis, and less renal injury [1][2][3][4]. Conversely, concerns regarding the technique include a limited ability to remove air leading to greater risk of stroke, longer cardiopulmonary bypass and cross-clamp times, limited exposure of mitral valve leading to suboptimal outcomes, and a greater risk of aortic dissection during arterial cannulation [5][6][7].…”

Long-term outcomes following minimal invasive versus conventional aortic valve replacement: a propensity match analysis

“…In this study, the postoperative pain intensity was measured with the use of the pain scale with reference numbers from 1 to 10 and the patients in both study groups had the same pain perception postoperatively. On the contrary, Yamada et al (28) in a retrospective study demonstrated that mini-invasive patients had earlier recovery and improved quality of life with diminished pain medication administration compared to the conventional AVR population. Other authors (29,30) demonstrated similar results.…”