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Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach.
- Source :
-
Journal of clinical medicine [J Clin Med] 2023 Oct 24; Vol. 12 (21). Date of Electronic Publication: 2023 Oct 24. - Publication Year :
- 2023
-
Abstract
- Introduction: The most common minimally invasive approach for aortic valve replacement (AVR) is the partial upper mini-sternotomy. The aim of this study is to understand which preoperative computed tomography (CT) features are predictive of longer operations in terms of cardio-pulmonary bypass timesand cross-clamp times.<br />Methods: From 2011 to 2022, we retrospectively selected 246 patients which underwent isolated AVR and had a preoperative ECG-gated CT scan. On these patients, we analysed the baseline anthropometric characteristics and the following CT scan parameters: aortic annular dimensions, valve calcium score, ascending aorta length, ascending aorta inclination and aorta-sternum distance.<br />Results: We identified augmented body surface area (>1.9 m <superscript>2</superscript> ), augmented annular diameter (>23 mm), high calcium score (>2500 Agatson score) and increased aorta-sternum distance (>30 mm) as independent predictors of elongated operation times (more than two-fold).<br />Conclusions: Identifying the preoperative predictive factors of longer operations can help surgeons select cases suitable for minimally invasive approaches, especially in a teaching context.
Details
- Language :
- English
- ISSN :
- 2077-0383
- Volume :
- 12
- Issue :
- 21
- Database :
- MEDLINE
- Journal :
- Journal of clinical medicine
- Publication Type :
- Academic Journal
- Accession number :
- 37959183
- Full Text :
- https://doi.org/10.3390/jcm12216717