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OBJECTIVE:
The purpose of this study was to report our experience with a new technique of bilateral anterior mini-thoracotomies for aortic valve replacement and coronary artery bypass grafting. This technique has not yet been reported in the literature.
METHODS:
A retrospective chart review of all patients undergoing the procedure was undertaken. The charts were reviewed for patient demographics, operative characteristics and post-operative outcomes.
RESULTS:
10 patients (7 male, 3 female) with a mean age of 68 +/- 5 years underwent the procedure. The were no operative or hospital deaths. All patients had a bioprosthesis implanted for aortic stenosis. 9 patients underwent concomitant grafting to the LAD, 1 patient to the diagonal. 3 patients had preoperative PCI with DES. The LIMA was used in 7 cases and SVG in 3 (2 LAD, 1 diag). The IMA was harvested directly in 2 cases and using the surgical robot in 5. All grafts were performed with the heart arrested. Mean CPB time was 88 +/- 22 mins and AoXC 67 +/- 10 mins. Intubation time was 480 +/- 110 mins. CT drainage was 680 +/- 220 mls. Mean ICU stay was 20 hours. Hospital LOS was 6.1 days. Complications included pleural effusion requiring drainage in 2 patients.
CONCLUSIONS:
In this small series less invasive AVR and CABG via bilateral mini-thoracotomies was found to be safe and reproducible. This procedure is a logical combination of well established techniques. Preoperative stenting increased candidacy and was not associate with adverse outcomes.