Minimally invasive aortic valve replacement using right minithoracotomy is associated with better outcomes than ministernotomy

Abstract

Objective To compare the outcomes of right minithoracotomy (RT) versus ministernotomy (MS) in patients undergoing minimally invasive aortic valve replacement (AVR). Methods From January 2005 to December 2011, 406 patients underwent minimally invasive AVR, of whom 251 patients were in the RT group and 155 were in the MS group. Results The overall in-hospital mortality was 1.2% with no difference between the 2 groups (1.2% in RT vs 1.3% in MS). Patients undergoing minimally invasive AVR using RT had a lower incidence of postoperative atrial fibrillation (19.5% vs 34.2%, P =.01), shorter ventilation time (median, 7 vs 8 hours; interquartile range, 5-9 vs 6-12 hours, P =.003), intensive care unit stay (median 1 vs 1 day; interquartile range, 1-1 vs 1-2 days; P =.001), and hospital stay (median, 5 vs 6 days; interquartile range, 5-6 vs 5-8 days; P =.0001). No difference was found in terms of cardiopulmonary time, crossclamping time, postoperative stroke, re-exploration for bleeding, or blood transfusion. Conclusions Minimally invasive AVR using RT was associated with lower postoperative morbidities and a shorter hospital stay than MS. © 2014 by The American Association for Thoracic Surgery.