Back to 2025 Cardiac Abstracts
Minimally Invasive Versus Conventional Open David Procedure For Valve Sparing Aortic Root Replacement: A Systematic Review And Meta-analysis
Kristine Santos1, Mislav Planinc, MD
2.
1NVU, Tbilisi, Georgia,
2Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
BACKGROUND: Minimally invasive aortic valve surgeries have shown favourable outcomes, prompting their adoption for more complex operations like David procedure (DP) for valve-sparing aortic root replacement. However, data comparing minimally invasive (MI-DP) and conventional open (CO-DP) approaches remain limited due to technical complexities. This meta-analysis aimed to compare the postoperative outcomes of MI-DP and CO-DP.
METHODS: We systematically searched MEDLINE, Scopus, and Cochrane Library, focusing on studies that compared MI-DP and CO-DP. Pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using RevMan 8.11.0. A subgroup analysis of only propensity-matched studies (PMS) was also performed.
RESULTS: We included seven observational studies involving 1,127 patients. No significant differences were observed between MI-DP and CO-DP in cardiopulmonary bypass duration and 30-day mortality. Postoperative complications including neurological deficits, sternal wound infection, and reoperation for bleeding were comparable between the two groups. The subgroup analysis included four PMS encompassing 288 patients. This analysis revealed significant differences favouring MI-DP in ventilation time [MD -6.29 hours; 95% CI -7.15 to -5.42; p<0.05], blood loss [MD -85.55 mL; 95% CI -114.61 to -56.50; p<0.05], ICU stay [MD -0.72 days; 95% CI -1.03 to -0.42; p<0.05] and hospital length of stay [MD -2.45 days; 95% CI -3.72 to -1.18; p<0.05].
CONCLUSIONS: MI-DP represents a viable alternative to CO-DP, reducing mechanical ventilation time, blood loss, ICU, and hospital length of stay. Large-scale randomised studies with extended follow-up are necessary to validate our findings.
Back to 2025 Cardiac Abstracts
