Minimally Invasive Aortic Valve Replacement With Central Cannulation: Evolution In A Developing Country
Mohammed A. Sanad, Hatem Beshir.
Mansoura University, Mansoura, Egypt.
Abstract Objective: With Development of Less invasive approaches to aortic valve surgery (MIAVR), they are becoming more technically and logistically demanding. However, in some developing countries, few centers have started using these approaches with standard equipment. We sought to intervene intraoperative and post-operative clinical outcomes after MIAVR. Methods: From June 2015 to present, a total of 15 patients had underwent isolated aortic valve surgery, via upper Inverted T upper hemisternotomy in Mansoura University Hospital, Egypt. Central cannulation and equipment were used in all cases. Cases with heavy calcifications with included. Major adverse cardiac events were compared to standard Aortic Valve replacement. Respiratory functions were performed to the patients one-week post operatively. Results: Exposure and feasibility for cannulation were assessed. The mean length of skin incision was 5.1±0.2 cm. No In-hospital mortality was recorded. However, 24-hour mediastinal drainage was comparable to standard median sternotomy approach. Fewer patients received transfusions. Early after operation, pain scores were lower after MIAVR and shorter postoperative length of stay shorter. Conclusions: With lack of logistics and equipment in developing countries, MIAVR not only remains a cosmetic advantage, but a significant reduction of blood product use, respiratory, pain, and resource utilization advantages over full sternotomy with no changes in equipment. MIAVR can be feasible, with a rapid learning curve in developing centers.
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