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International Society For Minimally Invasive Cardiothoracic Surgery

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Quality Of Life And Pulmonary Function After Minimally Invasive Aortic Valve Replacement Surgery: A Systematic Review
Matthew Hackney.
University of Bristol, Bristol, United Kingdom.

BACKGROUND: Aortic valve replacement surgery (AVR) via midline sternotomy is the standard surgical intervention used for AVR, however a minimally invasive approach is becoming more widely used. This review focuses on quality of life (QoL) and pulmonary function after minimally invasive AVR (MIAVR). The aim of this review is to comprehensively analyse the current body of evidence of the QoL and pulmonary function after MIAVR. A second aim is to see whether a conclusion can be made on the current literature: is the minimally invasive technique more beneficial to the patient over conventional full sternotomy approach, and therefore should this be standard practice going forward? METHODS: A thorough literature search was conducted in the PubMed database, using relevant searches. Papers were either included or excluded based on their title. Through a cross reference check from the papers identified by the search, further articles were identified. RESULTS: Several studies compared postoperative QoL between MIAVR and full sternotomy AVR (FSAVR). Some had no significant differences between the groups, however a couple were able to show differences in some categories within the ShortForm-36 such as a more improved ‘physical function’ and ‘physical role function’. With regards to pulmonary function, several studies showed a greater improvement in both FEV1 and FVC postoperatively in the MIAVR group. CONCLUSIONS: Overall, MIAVR can be performed with acceptable postoperative QoL and pulmonary function, and with added benefits in postoperative lung function over FSAVR. The literature currently available is sparse, so in terms of which approach is more beneficial to the patient, more well-designed, blind studies, especially randomised controlled trials with larger sample sizes, are needed in order to draw more definitive conclusions.


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