Avtor/Urednik		Jug, Jure; Štor, Zdravko; Geršak, Borut
Naslov		Anatomical circumstances and aortic cross-clamp time in minimally invasive aortic valve replacement
Tip		članek
Leto izdaje		2020
Obseg		str. str.
ISSN		1569-9293 - Interactive cardiovascular and thoracic surgery
Jezik		eng
Abstrakt		Objectives: Prolonged operative times, potentially leading to increased morbidity, are a possible drawback of minimally invasive aortic valve replacement. The aim of this study was to assess the impact of anatomical circumstances in the chest on aortic cross-clamp time. Methods: This retrospective study included 68 patients who underwent minimally invasive aortic valve replacement with the Perceval sutureless valve via right-anterior thoracotomy or with ministernotomy. Anatomical variables were measured during preoperative computer tomography scans. Results: Aortic cross-clamp time was shorter in those having ministernotomy than in the right-anterior thoracotomy group (41.1 vs 52.3 min; P < 0.001). Cardiopulmonary bypass (CPB) time was not significantly different between groups (P = 0.09). A multivariable linear-regression model (P = 0.018) showed the aortic dextroposition variable to be a significant predictor of the aortic cross-clamp method and CPB times (P = 0.005 and P = 0.003) independent of other anatomical variables in the right thoracotomy group (10 mm deviation from optimal position prolonged the times for 240 and 600 s). For the whole cohort, a correlation between aortic valve dimensions and operative times was found (P = 0.046, P = 0.009). A linear-regression model (P = 0,046) predicted 90 s longer aortic cross-clamp time and 231 s longer CPB time for every 1 mm smaller aortic valve diameter. Conclusions: The anatomical variables are associated with the operative times in minimally invasive aortic valve replacement with sutureless valves. Considering this association, preplanning the procedure is recommended.
Proste vsebinske oznake		aortic valve replacement computed tomography minimally invasive surgery zamenjava aortne zaklopke računalniška tomografija minimalno invazivna kirurgija