Comparison Of Different Surgical Techniques For Ascending Aortic Surgery With Or Without Aortic Valve Involvement
Fatih Gumus, Mustafa Serkan Durdu.
Ankara University, ankara, Turkey.
BACKGROUND: We aimed to present our initial clinical experience and show the feasibility and safety of right anterior mini-thoracotomy approach for ascending aorta surgery with or without aortic valve involvement. METHODS: This single center study was included 112 patients who underwent ascending aortic replacement with or without aortic valve intervention, between September 2018 and November 2020. RAT was performed for 48 (42.8%) patients (RAT Group) and conventional median sternotomy was performed for 64 (57.1%) patients (CS Group).
RESULTS: Mean age of patients was 67.63±6.67 years, and 65.1% of patients were male. When we compared the aortic valve pathologies, there was no diference between two groups. When we compared the cardiopulmonary by pass time and aortic cross clamping time, as we expected, there were no significant differences between two groups. Total operating time was statistically significant lower in favor of RAT group (237.84±24.87 min vs 259.57±27.41 min, respectively, p=0.0001). When we compared the postoperative variables of patients between the RAT group and the sternotomy group, the mean ventilation time (12.73±2.96 hours versus 19.43±4.21 hours) and the mean ICU length of stay (1.71±0.86 days versus 3.6±1.71 days) were both shorter in the RAT group (p<0.0001 for both). While length of hospital was significantly shorter in RAT group compared to sternotomy group (7.48±0.91 days versus 10.6±1.43 days, p<0.0001), hospital mortality was similar between two groups. Conclusion: Right anterolateral minithoracotomy is a novel and promising approach for ascending aortic surgery with or without aortic valve involvement. This study suggests that this approach is both feasible and safe.
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