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OBJECTIVE:
The use of minimally invasive (MI) surgical techniques is gaining in popularity. Our institution began MI aortic valve (AVR) surgery in late 2007. Since this time several new aortic valves have been introduced. The objective of this study was to determine whether the type of valve used made a difference in outcomes following MI AVR surgery.
METHODS:
All cardiac surgical patients are followed prospectively and data is locally stored in the Society of Thoracic Database. Health related quality of life [HRQL, SF-12 and The Minnesota Living with Heart Failure Survey (MLHFS)] was obtained preoperatively and 6 and 12 months post surgery. Death was verified by the SSDI or National Death Index
RESULTS:
Since 2007, 121 patients have undergone isolated MI AVR surgery. The average age was: 64.7 (±13.3) years, ejection fraction 60.4 (± 8.0), and additive euroSCORE 5.1 (± 2.4); 61% were male. The majority of patients received the St Jude medical Epic stented porcine bioprosthetic valve (34%), followed by the Medtronic Mosaic porcine bioprothesis (27%) and Carpentier Edwards Perimount pericardial magna bioprothesis (17%). There were no operative deaths or deep sternal wounds. Eighty six percent (86%) of the patients received no blood products during their stay; there was 1 stroke and 4 reoperations for bleeding. The median length of score was 4.0 days. By 12 months HRQL and MLHFS had improved significantly. At 1 year there was 100% survival. There was no difference in outcomes based on the type of valve used.
CONCLUSIONS:
Patients who underwent a MI aortic valve replacement at our institution did exceptionally well as indicated both by clinical outcomes and patients’ significant increase in their HRQL. The type of valve used did not influence patient outcomes. The use of a minimally invasive approach for isolated aortic valve replacement should be considered whenever possible.