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Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach.

Authors :
Irace FG
Chirichilli I
Russo M
Ranocchi F
Bergonzini M
Lio A
Nicolò F
Musumeci F
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