| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;76:1101-1106
© 2003 The Society of Thoracic Surgeons
a Section of Cardiac Surgery, Department of Surgery, Georgetown University Hospital, Washington, DC, USA
b Section of Cardiac Surgery, Department of Surgery, Washington Hospital Center, Washington, DC, USA
c Division of Cardiothoracic Surgery, SUNY Downstate Health Science Center, New York, New York, USA
d Statistics and Computer Center, MedStar Research Institute, Washington, DC, USA
Accepted for publication April 18, 2003.
* Address reprint requests to Dr Corso, Section of Cardiac Surgery, Department of Surgery, Georgetown University Hospital, Suite 4005 PHC, 3800 Reservoir Rd NW, Washington, DC 20007, USA.
e-mail: paul.j.corso{at}medstar.net
BACKGROUND: Aortic valve replacement (AVR) through a partial sternotomy (mini-AVR) has been suggested to significantly reduce postoperative morbidity compared with conventional AVR. This study sought to investigate whether mini-AVR patients require fewer transfusions than patients who had conventional AVR.
METHODS: Of 511 patients who had AVR, 56 had mini-AVR and 455 had conventional AVR. A matched-case logistic regression analysis was used to adjust for these imbalances between groups.
RESULTS: No patient in the mini-AVR cohort required conversion to a conventional AVR. Cardiopulmonary bypass time was longer in the mini-AVR group compared with the conventional AVR group, with a median of 102 minutes (range, 78 to 119 minutes) versus 75 minutes (range, 61 to 96 minutes; p < 0.01) in the conventional AVR group. A total of 31 patients (55%) in the mini-AVR group and 336 patients (74%) in the conventional sternotomy group required transfusions during their hospital stay (p < 0.01). After adjusting for differences in preoperative risk factors, year of operation, and surgeon, by matching on propensity score, the differences were not statistically significant (odds ratio = 0.84, 95% confidence interval = 0.40 to 1.75, p = 0.63).
CONCLUSIONS: Mini-AVR produces better wound cosmesis and less surgical trauma but requires more time to perform. Matched-case analysis failed to show a significant difference in blood transfusion requirements after mini-AVR compared with the conventional AVR approach.
This article has been cited by other articles:
|
|
 |
|
  M. Tabata, R. Umakanthan, L. H. Cohn, R. M. Bolman III, P. S. Shekar, F. Y. Chen, G. S. Couper, and S. F. Aranki Early and late outcomes of 1000 minimally invasive aortic valve operations Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 537 - 541. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. K. Rosengart, T. Feldman, M. A. Borger, T. A. Vassiliades Jr, A. M. Gillinov, K. J. Hoercher, A. Vahanian, R. O. Bonow, and W. O'Neill Percutaneous and Minimally Invasive Valve Procedures: A Scientific Statement From the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group Circulation, April 1, 2008; 117(13): 1750 - 1767. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Murtuza, J. R. Pepper, R. DeL Stanbridge, C. Jones, C. Rao, A. Darzi, and T. Athanasiou Minimal Access Aortic Valve Replacement: Is It Worth It? Ann. Thorac. Surg., March 1, 2008; 85(3): 1121 - 1131. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tabata, S. F Aranki, J. A Fox, G. S Couper, L. H Cohn, and P. S Shekar Minimally Invasive Aortic Valve Replacement in Left Ventricular Dysfunction Asian Cardiovasc Thorac Ann, June 1, 2007; 15(3): 225 - 228. [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 |
