Does ministernotomy improve postoperative outcome in aortic valve operation? A prospective randomized study

Bonacchi, Massimo; Prifti, Edvin; Giunti, Guido; Frati, Giacomo; Sani, Guido

doi:10.1016/s0003-4975(01)03402-6

Cited by 243 publications

(263 citation statements)

References 14 publications

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“…In addition to that, the increased stability of the thoracic cage after upper partial ministernotomy and increased integrity of the pleural cavities allowed patients to be mobilized early and cough more efficiently, this was also reported by others (von Segesser et al, 1999). The significant reduction of postoperative lung function is not only influenced with the use of CPB but also by the length of incision (Bonacchi et al, 2002;Hallfeldt, Siebeck, Thetter, & Schweiberer, 1995).…”

Section: Respiratory Complicationsmentioning

confidence: 63%

“…These results have been considered as the main advantages of MIAVR over CAVR in earlier studies (Bang et al, 2012;Bonacchi et al, 2002;Doll et al, 2002;Tabata et al, 2008;von Segesser et al, 1999). Nevertheless, we could evaluate some of these results indirectly, by assessing other parameters, which gave us an idea about these results.…”

Section: Study Limitationsmentioning

confidence: 91%

“…In these reports, the most common advantages of this technique included decreased blood loss, less postoperative pain, decreased ventilation time, shorter ICU-and hospital stay and better cosmetic results (Bonacchi, Prifti, Giunti, Frati, & Sani, 2002;Doll et al, 2002;Tabata et al, 2008;von Segesser et al, 1999). In spite of that, randomized controlled trails as well as meta-analysis studies (Aris et al, 1999;J.…”

Section: Conventional Aortic Valve Replacement (Cavr) Through Full Stmentioning

confidence: 99%

“…Although, retrospective studies (Liu, Sidiropoulos, & Konertz, 1999;Vanoverbeke et al, 2004) as well as prospective randomized studies (Aris et al, 1999;Bonacchi et al, 2002) Doll and colleagues reported a non-significant difference between MIAVR and CAVR in regard to the type of the prostheses used, but the rate of the implanted mechanical prostheses (55% and 52%, p=0.8) was higher in both groups than the implanted bioprostheses (45% and 47%, p=0.8 respectively) (Doll et al, 2002). Bakir and associates also found no significant differences in the type of the used prostheses between MIAVR and CAVR groups, but the rate of the implanted bioprostheses was higher in both groups (76.6% and 79.2%, p=0.75) than the rate of the implanted mechanical prostheses (23.3% and 20.8%, p=0.55) (Bakir et al, 2006).…”

Section: Procedural Datamentioning

confidence: 99%

“…Background: CAVR via full sternotomy is a safe procedure providing excellent long-term outcomes (Bonacchi et al, 2002;Tabata et al, 2008;von Segesser et al, 1999). Over the past two decades, minimally access cardiac surgery has been increasingly adopted with the goal to reduce the invasiveness of surgical procedures and aiming in the same time to give the same quality, safety and results of the conventional surgery.…”

Section: Summary Of the Studymentioning

confidence: 99%

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015 * Propensity Score Analysis of Outcomes Following Minimally Invasive Versus Conventional Aortic Valve Replacement

Shehada

Voß

Elhmidi

et al. 2014

Interactive CardioVascular and Thoracic Surgery

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Section: Respiratory Complicationsmentioning

confidence: 63%

Section: Study Limitationsmentioning

confidence: 91%

Section: Conventional Aortic Valve Replacement (Cavr) Through Full Stmentioning

confidence: 99%

Section: Procedural Datamentioning

confidence: 99%

Section: Summary Of the Studymentioning

confidence: 99%

See 3 more Smart Citations

015 * Propensity Score Analysis of Outcomes Following Minimally Invasive Versus Conventional Aortic Valve Replacement

Shehada

Voß

Elhmidi

et al. 2014

Interactive CardioVascular and Thoracic Surgery

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Limited versus full sternotomy for aortic valve replacement

Kirmani

Jones

Malaisrie

et al. 2017

Cochrane Database of Systematic Reviews

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The evidence in this review was assessed as generally low to moderate quality. The study sample sizes were small and underpowered to demonstrate differences in outcomes with low event rates. Clinical heterogeneity both between and within studies is a relatively fixed feature of surgical trials, and this also contributed to the need for caution in interpreting results.Considering these limitations, there was uncertainty of the effect on mortality or extracorporeal support times with upper hemi-sternotomy for aortic valve replacement compared to full median sternotomy. The evidence to support a reduction in total hospital length of stay or intensive care stay was low in quality. There was also uncertainty of any difference in the rates of other, secondary outcome measures or adverse events with minimally invasive limited sternotomy approaches to aortic valve replacement.There appears to be uncertainty between minimally invasive aortic valve replacement via upper hemi-sternotomy and conventional aortic valve replacement via a full median sternotomy. Before widespread adoption of the minimally invasive approach can be recommended, there is a need for a well-designed and adequately powered prospective randomised controlled trial. Such a study would benefit from performing a robust cost analysis. Growing patient preference for minimally invasive techniques merits thorough quality-of-life analyses to be included as end points, as well as quantitative measures of physiological reserve.

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