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Minimally Invasive Aortic Valve Replacement via Right Minithoracotomy is Associated With Better Outcomes Compared to Ministernotomy.
Mattia Glauber, Antonio Miceli, Daniyar Gilmanov, Matteo Ferrarini, Filippo Santarelli, Stefano Bevilacqua, Alfredo G. Cerillo, Enkel Kallushi, Marco Solinas, Pier A. Farneti.
Fondazione Toscana G. Monasterio, Massa, Italy.

Objective: To compare early outcomes of right minithoracotomy (RT) versus ministernotomy (MS) in patients undergoing minimally invasive aortic valve replacement (MIAVR).
Methods: From January 2005 to December 2011, a total of 406 patients underwent MIAVR, of whom 251 patients had RT (RT group) and 155 patients had MS (MS group). Cardiopulmonary bypass was achived by direct ascending aortic cannulation and percutaneous venous cannulation.
Results: Overall in-hospital mortality was 1.1% with no difference between two groups (1.2% in RT vs 1% in MS). Patients undergoing MIAVR via RT had lower incidence of postoperative atrial fibrillation (21.3% vs 32.1%, p=0.014), shorter ventilation time (7 [range interquartile [RI] 5-9 vs 7 RI 6-12, p=0.004 ), intensive care unit (1, RI 1-1 vs 1 RI 1-2, p=0.001) and ward stay (5,RI 4-6 vs 6,RI 5-7, p=0.0001). No difference were found in terms of cardiopulmonary, cross clamping time, postoperative stroke, re-exploration for bleeding, blood transfusion. Discharge home was higher in the RT group (93% vs 70%, p=0.0001).
Conclusions: Minimally invasive aortic valve replacement vi right minithoracotomy is associated with lower postoperative morbidities and shorter hopital stay than ministernotomy.


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