학술논문

Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach.
Document Type
Article
Source
Journal of Clinical Medicine. Nov2023, Vol. 12 Issue 21, p6717. 12p.
Subject
*AORTIC valve transplantation
*COMPUTED tomography
*BODY surface area
*MINIMALLY invasive procedures
Language
ISSN
2077-0383
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. 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. Results. We identified augmented body surface area (>1.9 m2), 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). Conclusions. Identifying the preoperative predictive factors of longer operations can help surgeons select cases suitable for minimally invasive approaches, especially in a teaching context. [ABSTRACT FROM AUTHOR]