Back to 2015 Annual Meeting Display Posters

OBJECTIVE: Aortic valve replacement through an upper “J” sternotomy approach has been widely described in literature but reoperative surgery is currently being performed by the same minimally invasive access only in few centers. We describe our experience using a minimally invasive approach for redo aortic valve reoperation, analyzing the advantages and disadvantages of this technique.
METHODS: Between June 2007 and December 2014, a total of 149 consecutive adult patients underwent reoperative isolated aortic valve replacement at our Institution. Fifty-six of them had minimally invasive approach. There were 34 male (60.7 %) with a mean age of 70.8±12.2 years (range: 30-84 years). Thirty-six patients had patent bypass grafts and 23 had previously heart valve replacement or repair. Eight patients had endocarditis as aetiology.
RESULTS: All 56 patients received an aortic valve replacement through an upper “J” ministernotomy using a central arterial and venous cannulation. Mean cardiopulmonary bypass time and mean cross-clamp time were respectively 72.7±25.5 min and 56.5± 22.0 min. Median Post operative ventilation time and intensive care unit stay were respectively 7 hours (3-408) and 82.6 hours (20-595). One patient had neurological complication, five patients needed pace-maker implantation. No sternal complications occurred. One patient with by endocarditis died during the hospital stay (mortality 1.8 %).
CONCLUSIONS: The main principle of minimally invasive surgery is to reduce biological aggressiveness. It means a short surgery operating time, less blood loos and lower risk of sternal instability or infection. Minimally invasive aortic valve surgery reoperation proved to be safe and reproducible procedure with excellent results in terms of hospital morbidity and mortality rates. Our results and those in recent literature are encouraging.