Respiratory System Function in Patients after Minimally Invasive Aortic Valve Replacement Surgery

Objective The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. Methods Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. Results Complications of the respiratory system occurred in 16.8% of AVR and 11.0% of RT-AVR patients ( P = 0.067). The rate of pleural effusions, thoracenteses, pneumonias, or phrenic nerve dysfunctions was not significantly different between groups. Perioperative mortality was 1.9% in AVR and 1.0% in RT-AVR ( P = 0.417). Mechanical ventilation time after surgery was 9.7 ± 5.9 hours for AVR and 7.2 ±3.2 hours for RT-AVR patients ( P < 0.001). Stroke (odds ratio [OR] = 13.4, P = 0.008), increased postoperative blood loss (OR = 9.6, P <0.001), and chronic obstructive pulmonary disease (OR = 7.7, P < 0.001) were risk factors of prolonged mechanical lung ventilation. A week after surgery, the results of most pulmonary function tests were lower in the AVR than in the RT-AVR group ( P < 0.001 was seen for forced expiratory volume in the first second, vital capacity, total lung capacity, maximum inspiratory pressure and maximum expiratory pressure, P = 0.377 was seen for residual volume). Conclusions Right anterior aortic valve replacement minithoracotomy surgery with single-lung ventilation did not result in increased rate of respiratory system complications. Spirometry examinations revealed that pulmonary functional status was more impaired after AVR in comparison with RT-AVR surgery.

Download Full-text

Decision support system for the planning of minimally invasive aortic valve replacement surgery

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-018-1725-7 ◽

2018 ◽

Vol 13 (8) ◽

pp. 1245-1255

Author(s):

Hui Li ◽

Miguel Castro ◽

Pascal Haigron ◽

Jean-Philippe Verhoye ◽

Vito Giovanni Ruggieri

Keyword(s):

Decision Support ◽

Aortic Valve ◽

Decision Support System ◽

Aortic Valve Replacement ◽

Minimally Invasive ◽

Valve Replacement ◽

Support System ◽

Replacement Surgery ◽

Valve Replacement Surgery

Download Full-text

Results of minimally invasive aortic valve replacement surgery through right thoracotomy at Hanoi Heart Hospital

Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam ◽

10.47972/vjcts.v35i.677 ◽

2021 ◽

Vol 35 ◽

pp. 56-66

Author(s):

Nguyen Sinh Hien ◽

Nguyen Minh Ngoc ◽

Nguyen Thai Minh ◽

Nguyen Dang Hung ◽

Dang Quang Huy ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Minimally Invasive ◽

Valve Replacement ◽

Replacement Surgery ◽

Right Thoracotomy ◽

Early Results ◽

Heart Hospital ◽

Valve Replacement Surgery

Objectives: To evaluate results of minimally invasive aortic valve replacement surgery through right thoracotomy with some techinque improvements in Hanoi Heart Hospital. Methods: Surgery was performed via a small right thoracotomy in the second intercostal space. The third rib was detached by a wedge-shaped way using sternum saw. Cannulation approaches were central or peripheral depended on patients’ condition. Preoperative, perioperative, early results and follow-up data was collected and analysed. Results: There was 48 patients in the research. Mean age was 60,94 ± 11,53 (25-82), and 52,1% was male. 29,2% of patients had peripheral vascular disease. 22,9% underwent central arterial cannulation. 3 patients (6,3%) had pericardial adhesion. There was no early mortality, 2 patients had redo surgery due to excess bleeding. 1 patients had intestinal infarction. Mean follow-up time was 13,4 months. 91,3% of patients had NYHA I. 1 patients was dead due to intracerebral hemorrhage. Conclusions: With some improvements in techniques, minimally invasive aortic valve replacement surgery through right thoracotomy gave good early and midterm results in our center.

Download Full-text

Right ventricular mechanics and contractility after aortic valve replacement surgery: a randomised study comparing minimally invasive versus conventional approach

Open Heart ◽

10.1136/openhrt-2018-000842 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000842 ◽

Cited By ~ 2

Author(s):

Nashmil Hashemi ◽

Jonas Johnson ◽

Lars-Åke Brodin ◽

Andreia Gomes-Bernardes ◽

Ulrik Sartipy ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Minimally Invasive ◽

Valve Replacement ◽

Longitudinal Strain ◽

Randomised Study ◽

Replacement Surgery ◽

Longitudinal Function ◽

Rv Function ◽

Valve Replacement Surgery

ObjectiveMinimally invasive aortic valve replacementsurgery (MIAVR) is an alternative surgical technique to conventional aortic valve replacement surgery (AVR) in selected patients. The randomised study Cardiac Function after Minimally Invasive Aortic Valve Implantation (CMILE) showed that right ventricular (RV) longitudinal function was reduced after both MIAVR and AVR, but the reduction was more pronounced following AVR. However, postoperative global RV function was equally impaired in both groups. The purpose of this study was to explore alterations in RV mechanics and contractility following MIAVR as compared with AVR.MethodsA predefined post hoc analysis of CMILE consisting of 40 patients with severe aortic valve stenosis who were eligible for isolated surgical aortic valve replacement were randomised to MIAVR or AVR. RV function was assessed by echocardiography prior to surgery and 40 days post-surgery.ResultsComparing preoperative to postoperative values, RV longitudinal strain rate was preserved following MIAVR (−1.5±0.5 vs −1.5±0.4 1/s, p=0.84) but declined following AVR (−1.7±0.3 vs −1.4±0.3 1/s, p<0.01). RV longitudinal strain reduced following AVR (−27.4±2.9% vs −18.8%±4.7%, p<0.001) and MIAVR (−26.5±5.3% vs −20.7%±4.5%, p<0.01). Peak systolic velocity of the lateral tricuspid annulus reduced by 36.6% in the AVR group (9.3±2.1 vs 5.9±1.5 cm/s, p<0.01) and 18.8% in the MIAVR group (10.1±2.9 vs 8.2±1.4 cm/s, p<0.01) when comparing preoperative values with postoperative values.ConclusionsRV contractility was preserved following MIAVR but was deteriorated following AVR. RV longitudinal function reduced substantially following AVR. A decline in RV longitudinal function was also observed following MIAVR, however, to a much lesser extent.

Download Full-text