| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;68:1525-1528
© 1999 The Society of Thoracic Surgeons
a Minneapolis Heart Institute, Minneapolis, Minnesota, USA
Address reprint requests to Dr Arom, Cardiac Surgical Associates PA, Minneapolis Heart Institute and St. Paul Heart Lung Clinic, 920 E 28th St, Suite 420, Minneapolis, MN 55407
Presented at Evolving Techniques and Technologies in Minimally Invasive Cardiac Surgery, San Antonio, TX, Jan 22–23, 1999.
Abstract
Background. Valvular operations have followed coronary artery bypass grafting as procedures that are amenable to a minimally invasive approach. This study is a review of our brief experiences of less invasive valve surgery (LIVS) through a partial sternotomy approach and port-access valve surgery (PAVS) with an attempt to compare safety and cost-effectiveness of the surgical procedure and post-discharge follow-up.
Methods. Forty PAVS and 66 LIVS procedures performed between May 1996 and December 1998 were reviewed. The PAVS patients were younger, included more men, and had greater left ventricular function. Aside from these particular data points, there was no significant difference in preoperative variables between groups.
Results. Operating room time, surgery time, and cross-clamp time were significantly longer in the PAVS group. The operative mortality was 3% (LIVS) and 5% (PAVS). There was more new atrial fibrillation in LIVS (26% versus 5%, p = 0.009). Postoperative follow-up revealed 77% of LIVS and 76% of PAVS patients had returned to work and more than 95% of the retired patients in both groups had resumed their daily activities. Importantly, PAVS patients returned to work about 4 weeks sooner than LIVS patients did.
Conclusions. Early clinical outcomes are comparable between the two approaches, which indicates safety and importance of appropriate patient selection. More follow-up is required to assess postoperative pain and cosmetic satisfaction. At the present time, LIVS appears to be more cost-effective. Early return to work in the PAVS group may be the most important finding to further support the port-access approach. However, with practice pattern changes and increased intraoperative efficiencies, each of these two surgical techniques may continue to have an important role in the minimally invasive valve surgery arena.
This article has been cited by other articles:
|
|
 |
|
  W. R. Chitwood Jr. and E. Rodriguez Minimally Invasive and Robotic Mitral Valve Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 1079 - 1100. [Full Text]
|
|
|
|
 |
|
 W. F. Northrup III, R. W. Emery, D. M. Nicoloff, T. J. Lillehei, A. R. Holter, and D. P. Blake Opposite trends in coronary artery and valve surgery in a large multisurgeon practice, 1979-1999 Ann. Thorac. Surg., February 1, 2004; 77(2): 488 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. R. Chitwood Jr. and L. W. Nifong Minimally Invasive and Robotic Valve Surgery Card. Surg. Adult, January 1, 2003; 2(2003): 1075 - 1092. [Full Text]
|
|
|
|
|
|
P. Schroeyers, F. Wellens, R. De Geest, I. Degrieck, F. Van Praet, Y. Vermeulen, and H. Vanermen Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience Ann. Thorac. Surg., September 1, 2001; 72(3): S1050 - 1054. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
