MI-AVR) in patients with aortic valve disease. Hypothesis: We hypothesize that MI-AVR provides good long-term clinical outcomes in patients undergoing aortic valve surgery. Methods: All consecutive 1,972 patients undergoing MI-AVR with either ministernotomy (n= 986) or right anterior minithoracotomy (RAM, n=986) between 1999 and 2019, were included. Primary outcomes were all-cause mortality and cardiac death. Results: Preoperatively, mean age was 72.1 (±13.7) year-old, and mean STS-PROM risk score was 0.38%. Intraoperatively, mean operative time (min) was 213.97 (± 56.9), while 313 (15.9%) patients were converted to full sternotomy. Postoperatively, 69 (3.5%) patients had prolonged mechanical ventilation (< 24 hours), 59 (3%) patients had re-exploration for bleeding, 10 (0.5%) patients had paravalvular leak (moderate/severe), 22 (1.1%) patients had non-fatal stroke, and 28 (1.4%) patients had non-fatal myocardial infarction. Mean intensive care unit stay was 14.45 (± 10.15) hours, and mean hospital length of stay (LOS) was 7 (± 3.5) days. Thirty-day all-cause mortality occurred in 39 (2%) patients while 30-day cardiac-death occurred in 23 (1.2%) patients. Thirty-day predictors for all-cause mortality included age <75-years, post-operative LOS, peri-operative stroke, and RAM. Mean follow-up time was 10-years. At 20-year follow-up, all-cause death and CV-death incidence were 1156 (60%) and 170 (8.8%) patients, respectively. Valve-related deaths occurred in 33 (1.7%) patients. Long-term predictors for all-cause mortality included age <75-years, chronic kidney failure, mechanical ventilation <12 hours, RAM, and hospital LOS <10 days. Conclusions: MI-AVR is a safe, valid, and reproducible surgical procedure for patients with aortic valve disease. In addition, it provides good long-term outcomes.

Long-Term Clinical Outcomes of Minimally Invasive Aortic Valve Surgery in Patients With Aortic Valve Disease / Dokollari,Aleksander; Torregrossa,Gianluca; Cabrucci,Francesco; Gemelli,Marco; Rodriguez,Roberto; Prifti,Edvin; Pompeu Sa,Michel; Bacchi,Beatrice; Goldman,Scott; Fatehi Hassanabad,Ali; Sicouri,Serge; Basel,Ramlawi; Bonacchi,Massimo. - In: CIRCULATION JOURNAL. - ISSN 1347-4820. - STAMPA. - 148:(2023), pp. 11695-11696. [10.1161/circ.148.suppl_1.11695]

Long-Term Clinical Outcomes of Minimally Invasive Aortic Valve Surgery in Patients With Aortic Valve Disease

Cabrucci,Francesco;Bacchi,Beatrice;Bonacchi,Massimo
2023

Abstract

MI-AVR) in patients with aortic valve disease. Hypothesis: We hypothesize that MI-AVR provides good long-term clinical outcomes in patients undergoing aortic valve surgery. Methods: All consecutive 1,972 patients undergoing MI-AVR with either ministernotomy (n= 986) or right anterior minithoracotomy (RAM, n=986) between 1999 and 2019, were included. Primary outcomes were all-cause mortality and cardiac death. Results: Preoperatively, mean age was 72.1 (±13.7) year-old, and mean STS-PROM risk score was 0.38%. Intraoperatively, mean operative time (min) was 213.97 (± 56.9), while 313 (15.9%) patients were converted to full sternotomy. Postoperatively, 69 (3.5%) patients had prolonged mechanical ventilation (< 24 hours), 59 (3%) patients had re-exploration for bleeding, 10 (0.5%) patients had paravalvular leak (moderate/severe), 22 (1.1%) patients had non-fatal stroke, and 28 (1.4%) patients had non-fatal myocardial infarction. Mean intensive care unit stay was 14.45 (± 10.15) hours, and mean hospital length of stay (LOS) was 7 (± 3.5) days. Thirty-day all-cause mortality occurred in 39 (2%) patients while 30-day cardiac-death occurred in 23 (1.2%) patients. Thirty-day predictors for all-cause mortality included age <75-years, post-operative LOS, peri-operative stroke, and RAM. Mean follow-up time was 10-years. At 20-year follow-up, all-cause death and CV-death incidence were 1156 (60%) and 170 (8.8%) patients, respectively. Valve-related deaths occurred in 33 (1.7%) patients. Long-term predictors for all-cause mortality included age <75-years, chronic kidney failure, mechanical ventilation <12 hours, RAM, and hospital LOS <10 days. Conclusions: MI-AVR is a safe, valid, and reproducible surgical procedure for patients with aortic valve disease. In addition, it provides good long-term outcomes.
2023
148
11695
11696
Dokollari,Aleksander; Torregrossa,Gianluca; Cabrucci,Francesco; Gemelli,Marco; Rodriguez,Roberto; Prifti,Edvin; Pompeu Sa,Michel; Bacchi,Beatrice; Gol...espandi
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1344896
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