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New York City Conference

Back to 2014 Annual Meeting Abstracts


Outcomes of a Minimally Invasive Right Anterior Thoracotomy Approach for Re-Operative Aortic Valve Surgery
Angelo LaPietra, Orlando Santana, Andres M. Pineda, Christos G. Mihos,
Joseph Lamelas.
Mount Sinai Medical Center, Miami Beach, FL, USA.

OBJECTIVE:
We sought to evaluate the feasibility, safety, and short-term outcomes of patients who requiring re-operative aortic valve replacement performed via a minimally invasive right anterior thoracotomy approach.
METHODS: We retrospectively reviewed all the re-operative minimally invasive aortic valve replacements performed at our institution between January 1, 2009 and February 28, 2013. The operative times, intensive care unit and hospital lengths of stay, post-operative complications, and mortality were analyzed.
RESULTS: A total of 79 consecutive patients with aortic valve disease requiring re-operative aortic valve replacement performed via a minimally invasive right anterior thoracotomy approach were identified. The mean age was 75 ± 9 years, and 61 of the patients were males (77.2%). The mean left ventricular ejection fraction was 51 ± 12%. Previous surgeries included: 61 (77.2%) coronary artery bypass graft surgery, 17 (21.5%) aortic valve replacement, 10 (12.7%) mitral valve surgery, and 12 (15.2%) combined coronary artery bypass graft and valve surgery. The median aortic cross clamp and cardiopulmonary bypass times were 96 minutes (IQR 84-125) and 144 minutes (IQR 121-178), respectively. The median intensive care unit and hospital lengths of stay were 45 hours (IQR 32-85) and 8 days (IQR 6-11), respectively. There were 2 cerebrovascular accidents (2.25%), 3 re-operations for bleeding (3.79%) and no conversions to sternotomy. The overall 30-day mortality was 5 (6.33%).
CONCLUSIONS: Minimally invasive re-operative aortic valve replacement via a right anterior thoracotomy approach can be performed safely with a low morbidity and mortality.


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