Aortic valve replacement using a stentless bioprosthesis through right minithoracotomy: an initial experience.

摘要: Objective Aortic valve replacement (AVR) is nowadays a safe procedure with low rates of mortality and morbidity, but the necessity for less invasive approach going to increase. The use stentless prosthesis through right mini-thoracotomy has not yet been described our experience could be useful other surgeons. Methods From June 2009 until March 2010, seven female patients (mean age 79.9 ± 5.7 years) underwent stentless-AVR aortic stenosis (RM). logistic Euroscore was 11.3 ± 6.1, left ventricular ejection fraction 60.7 ± 4.5%. In five cases RM performed second intercostal space (ICS); in two third ICS. cannulation most between ascending aorta femoral vein (5/7). When transverse sternotomy required (two patients), mammary artery clipped cut. Results Extracorporeal circulation time (ECC) 110 ± 41 min cross clamp 80 ± 35 min. Two sternotomy. mean bleeding 484 ± 469 ml duration mechanical ventilation 22.0 ± 12.5 h. ICU stay 3.3 ± 2.2 days. No in-hospital death observed. hospital 11.6 ± 5.4 Conclusion Right applicable even case AVR using prosthesis. risk insufficient surgical exposure or complication may safely managed, by enlarging thoracotomy However, implantation more difficult than standard it requires an expert confident surgeon large implantation.