Elhassan Hind, Abdelbar Abdelrahman, Taylor Rebecca, Laskawski Grzegorz, Saravanan Palanikumar, Knowles Andrew, Zacharias Joseph
Department of Cardiothoracic Surgery, Blackpool Teaching Hospitals NHS Foundation Trust, Whinney Heys Rd, Blackpool FY3 8NR, UK.
J Cardiovasc Dev Dis. 2022 Jan 28;9(2):44. doi: 10.3390/jcdd9020044.
(1) Background: Minimal invasive cardiac surgery via right anterolateral thoracotomy for heart valve surgery and other intracardiac procedures proven to have lower postoperative complications. We aim to compare the neurological complications and post-operative outcomes in two cohort groups as well as survival rates up to 5 years postoperatively; (2) Methodology: Retrospective observational study for patients who had minimally invasive cardiac valve surgery with retrograde femoral arterial perfusion between 2007 and 2021 ( = 596) and the categorized patients into two groups based on their age (≥70 years old and below 70). Propensity match analysis was conducted. The primary endpoint consisted of major postoperative complications and the secondary endpoint was the long-term survival rate. (3) Results: There was no difference between the two groups in terms of postoperative outcomes. Patients ≥ 70 years old had no increased risk for neurological complications ( = 0.75) compared with those below 70 years old. The mortality rate was also not significant between the two groups ( = 0.37) as well as the crude survival rates. (4) Conclusions: The use of retrograde femoral arterial perfusion in elderly patients is not associated with increased risk compared to the younger patients' group for a spectrum of primary cardiac valve procedures. Hence, minimally invasive approaches could be offered to elderly patients who might benefit from it.
(1) 背景：经右前外侧开胸进行的微创心脏手术用于心脏瓣膜手术及其他心内手术，已证实术后并发症较少。我们旨在比较两个队列组的神经并发症和术后结局以及术后5年的生存率；(2) 方法：对2007年至2021年间接受微创心脏瓣膜手术并采用逆行股动脉灌注的患者进行回顾性观察研究（n = 596），并根据年龄将患者分为两组（≥70岁和70岁以下）。进行倾向匹配分析。主要终点包括术后主要并发症，次要终点是长期生存率。(3) 结果：两组术后结局无差异。≥70岁的患者与70岁以下的患者相比，神经并发症风险没有增加（p = 0.75）。两组之间的死亡率（p = 0.37）以及粗生存率也无显著差异。(4) 结论：与年轻患者组相比，老年患者使用逆行股动脉灌注进行一系列原发性心脏瓣膜手术时，风险并未增加。因此，可以为可能从中受益的老年患者提供微创方法。
