초록접수 현황
| 20F-197 | 구연 발표 |
Mini-Access Aortic Root Reimplantation Surgery: Early Results
Dong Youb Han, MD, Sung Jun Park, MD and Joon Bum Kim, MD, PhD
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Purpose : Despite wide acceptance of minimally-invasive approaches in heart valve surgeries, its application on valve-sparing root surgeries has been limited because of its technical difficulties and complexity. Here we present our early experiences with mini-access root reimplantation procedure.
Methods : The study enrolled 27 consecutive patients (age, 56.0±14.7years; 23 males; MINI group) who underwent mini-access David procedure from November 2018 to February 2020. Mini-access approach involved upper hemi-sternotomy down to 3rd or 4th intercostal space through a small incision (5-10cm). Concomitant hemiarch replacement and ablation of atrial fibrillation through roof approach were also included. To compare outcomes against standard sternotomy approach, 26 patients with equivalent procedures selected from 61 patients who underwent David procedure between 2015 and 2020 served as control (CONV group). For baseline adjustment, inverse-probability weighting was conducted.
Results : At baseline, majority of patients had severe aortic insufficiency (AI) in both groups (Table). Aortic clamping and cardiopulmonary bypass times were similar. There were no cases of early mortality or postoperative ECMO support while small numbers of complications occurred in either groups (Table). MINI group had shorter mechanical ventilation time and less amount of transfusion than CONV group (Table). Postoperative AI degree was similar for both groups with most remaining ≤ mild (Table). After baseline adjustment, the findings on the comparative postoperative outcomes were analogous to those of crude analyses.
Conclusion : Mini-access root reimplantation surgery showed excellent early postoperative outcomes equivalent or even superior to conventional sternotomy approach. These results should be further validated from larger experiences with long-term follow-up.
Methods : The study enrolled 27 consecutive patients (age, 56.0±14.7years; 23 males; MINI group) who underwent mini-access David procedure from November 2018 to February 2020. Mini-access approach involved upper hemi-sternotomy down to 3rd or 4th intercostal space through a small incision (5-10cm). Concomitant hemiarch replacement and ablation of atrial fibrillation through roof approach were also included. To compare outcomes against standard sternotomy approach, 26 patients with equivalent procedures selected from 61 patients who underwent David procedure between 2015 and 2020 served as control (CONV group). For baseline adjustment, inverse-probability weighting was conducted.
Results : At baseline, majority of patients had severe aortic insufficiency (AI) in both groups (Table). Aortic clamping and cardiopulmonary bypass times were similar. There were no cases of early mortality or postoperative ECMO support while small numbers of complications occurred in either groups (Table). MINI group had shorter mechanical ventilation time and less amount of transfusion than CONV group (Table). Postoperative AI degree was similar for both groups with most remaining ≤ mild (Table). After baseline adjustment, the findings on the comparative postoperative outcomes were analogous to those of crude analyses.
Conclusion : Mini-access root reimplantation surgery showed excellent early postoperative outcomes equivalent or even superior to conventional sternotomy approach. These results should be further validated from larger experiences with long-term follow-up.
책임저자: Joon Bum Kim, MD, PhD
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
발표자: Dong Youb Han, MD, E-mail : fhsvofm@naver.com