Rapid deployment aortic valve replacement through anterior right thoracotomy: Clinical outcomes and haemodynamic performance

J Card Surg. 2020 Jul;35(7):1420-1424. doi: 10.1111/jocs.14585. Epub 2020 Apr 27.

Abstract

Background: The ease of implantation of the rapid deployment (RD) and sutureless valves has contributed to the adoption of anterior right thoracotomy (ART) approach for aortic valve replacement (AVR).

Aim of the study: This study evaluates the safety and haemodynamic performance of minimally invasive AVR through ART using the RD valves.

Methods: This is a retrospective, single-center review of a total of 50 consecutive patients who received RD-AVR through ART.

Results: The median age of patients was 75 years (interquartile range [IQR]: 69-80), and median Euroscore II was 5.1 (IQR: 2.4-7.5). ART RD-AVR was successfully performed in all cases with no conversion to sternotomy, paravalvular leaks or need for valve explantation. The mean size of the implanted valve was 23.2 ± 2.3 mm. In-hospital mortality was 2%. The mean and maximum pressure gradients across the aortic prosthesis were 10 mm Hg (IQR: 9-12) and 19 mm Hg (IQR: 16-23).

Conclusions: Rapid deployment aortic valve replacement can be safely performed through anterior right thoracotomy wit excellent haemodynamic performance and low postoperative complications rate.

Keywords: anterior right thoracotomy; aortic valve replacement; minimally invasive; rapid deployment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Female
  • Heart Valve Prosthesis Implantation / methods*
  • Heart Valve Prosthesis*
  • Hemodynamics*
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Retrospective Studies
  • Sutureless Surgical Procedures / methods*
  • Thoracotomy / methods*
  • Treatment Outcome