TCT-45 Long-Term Clinical Outcomes of 986 Patients Undergoing Aortic Valve Replacement Through Right Anterior Minithoracotomy

We analyzed long-term clinical outcomes of aortic valve replacement (AVR) through right anterior minithoracotomy (MT-AVR). Methods This was a multicenter study of 986 patients undergoing MT-AVR from 1999 to 2019. Primary outcomes were incidence of all-cause mortality and cardiac death. Results Preoperatively, mean age was 71.54 ± 10 years, and mean STS-PROM risk score was 0.31% ± 0.22. Intraoperatively, CPB time was 65.64 ± 43.83 minutes, aortic cross-clamp time was 49.37 ± 36.56 minutes, 227 patients (23%) were converted to full-sternotomy, and 829 (84%) had femoral arterial cannulation. Postoperatively, mean intensive care unit stay was 16.5 ± 10.5 hours, mean hospital length of stay (LOS) was 8.7 ± 4.2 days, 9 patients (0.9%) had a nonfatal stroke, 17 (1.7%) had a nonfatal myocardial infarction, 38 (3.8%) had a reoperation for bleeding, and 7 (0.7%) had moderate/severe paravalvular leak. Thirty-day all-cause mortality incidence was 28/986 (2.8%), and cardiac death incidence was 17/986 (1.7%). Thirty-day risk predictors for all-cause death were age ˃75 years old, hospital LOS ˃10 days, and incidence of nonfatal stroke. Median follow-up time was 120.7 months. Long-term follow-up evidenced an overall survival at 1, 3, 5, 10, and 20 years of 92.4% ± 3.2%, 83.5% ± 4.7%, 78.2% ± 5.3%, 61.5% ±7.1%, and 35.4% ± 7.7%, respectively. Risk predictors for long-term all-cause mortality were age ˃75 years, CKD, prolonged ventilation ˃24 hours, and hospital LOS ˃10 days