Dumani Selman, Likaj Ermal, Dibra Laureta, Kuci Saimir, Rruci Edlira, Ibrahimi Alfred, Zaimi Petrela Elizana, Mehmeti Alessia, Beca Vera, Pellumbi Devis, Veseli Aferdita, Refatllari Ali, Veshti Altin
Division of Cardiac Surgery, University Hospital Center "Mother Theresa", Tirana, ALB.
Department of Anesthesiology, University Hospital Center "Mother Theresa", Tirana, ALB.
Cureus. 2024 Dec 30;16(12):e76652. doi: 10.7759/cureus.76652. eCollection 2024 Dec.
Minimally invasive aortic valve surgery is becoming more popular everyday. The most used approach is mini-sternotomy. There are several promoted benefits related with minimal invasive approaches in comparison with standard sternotomy. This study aimed to compare the early postoperative results of mini-sternotomy and standard sternotomy.
This is a retrospective study that compares minimal invasive with conventional sternotomy aortic valve surgery in terms of early results. The patients underwent surgery at the University Hospital Center "Mother Theresa", Tirana, Albania between July 17, 2017, and July 30, 2024. The data were collected from hospital registration. All data are presented as mean ± standard deviation. Key outcomes included early mortality, perioperative complications, and intraoperative and postoperative recovery times.
The study included 168 patients (95 males, 73 females) with a mean age of 62 ± 12.5 years. Standard sternotomy was used in 115 patients with a mean age of 63.93± 9.52 and mini-sternotomy was used in 53 patients with a mean age of 62.97 ± 10.47 without differences between them (P=0.633). The overall mortality was 1.2 % (four patients). There were no significant differences in mortality and incidence of perioperative complications between the two groups. The minimally invasive group had shorter intensive care unit (ICU) stay (39.92 ± 8.62 hours vs. 55.96 ± 32.56 hours, p < 0.001) and mechanical ventilation assistance duration (5.82 ± 2.44 hours vs. 10.41 ± 14.68 hours, p = 0.030).
The minimally invasive aortic valve replacement through mini-sternotomy is as safe as standard sternotomy. Mini-sternotomy clearly is related to significant shorter ICU stay time and mechanical respiratory assistance that can be traduced in lower hospital cost.
微创主动脉瓣手术日益普及。最常用的入路是微创胸骨切开术。与标准胸骨切开术相比，微创入路有多项宣称的益处。本研究旨在比较微创胸骨切开术和标准胸骨切开术的术后早期结果。
这是一项回顾性研究，比较微创与传统胸骨切开术主动脉瓣手术的早期结果。患者于2017年7月17日至2024年7月30日在阿尔巴尼亚地拉那的“特蕾莎修女”大学医院中心接受手术。数据从医院登记处收集。所有数据均以均值±标准差表示。主要结局包括早期死亡率、围手术期并发症以及术中和术后恢复时间。
该研究纳入了168例患者（95例男性，73例女性），平均年龄为62±12.5岁。115例患者采用标准胸骨切开术，平均年龄为63.93±9.52岁；53例患者采用微创胸骨切开术，平均年龄为62.97±10.47岁，两组之间无差异（P=0.633）。总死亡率为1.2%（4例患者）。两组之间的死亡率和围手术期并发症发生率无显著差异。微创组的重症监护病房（ICU）住院时间较短（39.92±8.62小时 vs. 55.96±32.56小时，p<0.001），机械通气辅助时间也较短（5.82±2.44小时 vs. 10.41±14.68小时，p=0.030）。
通过微创胸骨切开术进行的微创主动脉瓣置换术与标准胸骨切开术一样安全。微创胸骨切开术显然与显著缩短的ICU住院时间和机械通气辅助时间相关，这可转化为更低的医院成本。
