Minimal Invasive And Endovascular Approach For Surgical Treatment Of Patients With Isolated Aortic Stenosis
Mikhail Fomenko1, Yuri Schneider2, Victor Tsoi3, Alexander Pavlov3, Pavel Shilenko2.
1Federal Сenter of High Medical Technologies, Ministry of Health of the Russian Federation, Kaliningrad, Russian Federation, 2Federal Center of High Medical Technologies, Ministry of Health of the Russian Federation, Kaliningrad, Russian Federation, 3Federal center of High Medical Technologies, Ministry of Health of the Russian Federation, Kaliningrad, Russian Federation.
Background: Last 40 years aortic valve replacement the most common operation to treatment patients with isoleted degenerative disease of aortic valve. Minimally invasive approaches and transcatheter methods today become the most common and preferred in world practice aortic valve replacement. But each technique has limitations and advantages, and impossible to generalize one technique for all patients. The aim of our study was a retrospective analysis of minimally invasive and transcatheter approaches surgical treatment isolated aortic valve disease. Methods: Between October 2012 to December 2019, in our Center was performed 402 operations - isolated aortic valve replacement. According guidelines in 118 cases was performed mini-J sternotomy and 83 cases TAVI-procedure. Mean age in miniinvasive and TAVI groups was 57.7 ± 12 and 77.9 ± 10.5 years, respectively (p <0.001). In study prevailed female: 57.1% and 62.3%, respectively (p <0.001). Mean peak gradient on aortic valve was: 74.2 ± 19.8 and 76.2 ± 16.6 mm Hg., respectively (p = 0.862). Mean EuroScore II was 2.6 ± 0.5%. Results: Hospital mortality was 2 patients (2.4%) in TAVI group. Operations relation complications: complete atrioventricular block, interventricular septal defect, stroke, bleeding - not significantly differ (p = 1.0). Mean duration of operation was: 204.6 ± 25.7 and 65.5 ± 12.5 minutes. Mean intensive care was 1.6 ± 0.6 and 1.5 ± 0.5 days (p=0.566). Mean hospitalization time was 14.1 ± 5.1 and 15.4 ± 4.3 days (p=0.446). Conclusion: Despite the significant difference of patients surgical treatment of aortic valve by minimally invasive and transcatheter approaches is safe and effective procedure who demonstrated comparable results.
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