Comparison between conventional open-heart valve surgery and minimally invasive valve replacement surgery regarding the length of hospital stay and usage of blood derivates: insights from a single-centre, single-surgeon study conducted in Bosnia and Herzegovina
Aim To analyse the correlation between different surgical methodologies employed in valve diseases treatment and their subsequent impact on the duration of hospitalization. Methods This retrospective study conducted at the Clinical Centre of the University of Sarajevo analysed medical records of 163 valve disease patients treated between January 2019 and November 2022. The patients were divided into two groups: 77 had openheart valve surgery and 86 underwent minimally invasive cardiac surgery (MICS). Results The mean duration of the surgical procedures was 3.9±1.3 hours, with conventional open-heart surgery requiring an average of 3.6±1.1 hours and minimally invasive cardiac surgery (MICS) procedure 4.2±1.5 hours. No substantial disparities were found in the total length of hospitalization between the two groups, as both conventional (8.2±4.5 days) and MICS (8.7±7.0 days) demonstrated similar duration. Similarly, the total duration of intensive care unit (ICU) stay displayed similarity, with conventional surgery patients staying an average of 3.9±2.8 days and MICS patients of 4.2±4.1 days. The pattern of blood transfusion and fresh-frozen plasma usage revealed higher rates in the conventional valve surgery group comparing to the MICS group. Conclusion Minimally invasive valve surgery, despite slightly longer operative times, resulted in lower blood transfusion requirements and comparable hospitalization and ICU stay.
Cohn L. Minimally invasive valve surgery. J Card Surg. 2001. p. 260–5.
2.
Glauber M, Karimov J, Farneti P, Cerillo A, Santarelli F, Ferrarini M, et al. Minimally invasive mitral valve surgery via right minithoracotomy. Multimed Man Cardiothorac Surg. 2009.
3.
Tommaso D, Bruno E, V. Commentary: The rise of minimalism in cardiac surgery. JTCVS Tech. 2021. p. 67–8.
4.
Gulbins H, Pritisanac A, Hannekum A. Minimally invasive heart valve surgery: already established in clinical routine? Expert Rev Cardiovasc Ther. 2004. p. 837–43.
5.
Filip G, Bryndza M, Konstanty-Kalandyk J, Piatek J, Wegrzyn P, Ceranowicz P, et al. Ministernotomy or sternotomy in isolated aortic valve replacement? Early results. Kardiochir Torakochirurgia Pol. 2018. p. 213–8.
6.
Bonacchi M, Prifti R, Giunti G, Frati G, Sani G. Does ministernotomy improve postoperative outcome in aortic valve operation? A prospective randomized study. Ann Thorac Surg. 2002. p. 460–5.
7.
Kohorst K, Pretorius M. Future Technology. Semin Cardiothorac Vasc Anesth. 2019. p. 123–33.
8.
Harky A, Botezatu B, Kakar S, Ren M, Shirke M, Pullan M. Mitral valve diseases: Pathophysiology and interventions. Prog Cardiovasc Dis. 2021. p. 98–104.
9.
Wolfe J, Malaisrie S, Farivar R, Khan J, Hargrove W, Moront M, et al. Innovations (Phila). 2016. p. 251–9.
10.
Singh K, Anderson E, Harper J. Overview and management of sternal wound infection. Semin Plast Surg. 2011. p. 25–33.
11.
Abu-Omar Y, Fazmin I, Ali J, Pelletier M. Minimally invasive mitral valve surgery. J Thorac Dis. 2021. p. 1960–70.
12.
Kirmani B, Mazhar K, Fabri B, Pullan D. Comparison of the EuroSCORE II and Society of Thoracic Surgeons 2008 risk tools. Eur J Cardiothorac Surg. 2013. p. 999–1005.
13.
Shahian D, Jacobs J, Badhwar V, Kurlansky P, Furnary A, Cleveland J, et al. The Society of Thoracic Surgeons 2018 adult cardiac surgery risk models: Part 1-background, design considerations, and Model Development. Ann Thorac Surg. 2018. p. 1411–8.
14.
Glauber M, Ferrarini M, Miceli A. Minimally invasive aortic valve surgery: state of the art and future directions. Ann Cardiothorac Surg. 2015. p. 26–32.
15.
Movahed M, Etemad S, Hashemzadeh M. Hashemzadeh M. Persistent reduction in the age adjusted mortality rate from aortivc valve surgery in the United States with elimination of gender gap in recent years. Am J Cardiovasc Dis. 2020. p. 522–7.
16.
Schlösser F, Vaartjes I, Van Der Heijden G, Moll F, Verhagen H, Muhs B, et al. Mortality after elective abdominal aortic aneurysm repair. Ann Surg. 2010. p. 158–64.
17.
Berger J, Holubkov R, Reeder R, Wessel D, Meert K, Berg R, et al. Morbidity and mortality prediction in pediatric heart surgery: physiological profiles and surgical complexity. J Thorac Cardiovasc Surg. 2017. p. 620–8.
18.
Pope N, Ailawadi G. Minimally Invasive Valve Surgery. J Cardiovasc Transl Res. 2014. p. 387–94.
19.
Ko K, De Kroon T, Post M, Kelder J, Schut K, Saouti N, et al. Minimally invasive mitral valve surgery: a systematic safety analysis. Open Heart. 2020. p. 1393.
20.
Ullah W, Sattar Y, Mukhtar M, Abdullah H, Figueredo V, Haas D, et al. Outcomes of open mitral valve replacement versus transcatheter mitral valve repair; insight from the National Inpatient Sample Database. Int J Cardiol Heart Vasc. 2020. p. 100540.
21.
Iba Y, Yamada A, Kurimoto Y, Hatta E, Maruyama R, Miura S. Perioperative outcomes of minimally invasive aortic arch reconstruction with branched grafts through a partial upper sternotomy. Ann Vasc Surg. 2020. p. 217–23.
22.
Fishbein G, Fishbein M. Mitral Valve Pathology. Curr Cardiol Rep. 2019. p. 61.
23.
Grant S, Hickey G, Modi P, Hunter S, Akowuah E, Zacharias J. Propensity-matched analysis of minimally invasive approach versus sternotomy for mitral valve surgery. Heart. 2019. p. 783–9.
24.
Bergsland J, Mujanovic E, Elle O, Mirtaheri P. Fosse E. Minimally invasive repair of the mitral valve: technological and clinical developments. Minim Invasive Ther Allied Technol. 2011. p. 72–7.
25.
Sorajja P, Ukaigwe A. Edge-to-edge repair: past challenge, current case selection and future advances. Ann Cardiothorac Surg. 2021. p. 43–9.
26.
Shechter A, Lee M, Kaewkes D, Koren O, Skaf S, Chakravarty T, et al. Siegel RJ. Repeat mitral transcatheter edge-to-edge repair for recurrent significant mitral regurgitation. J Am Heart Assoc. 2023. p. 28654.
27.
Botta L, Cannata A, Bruschi G, Fratto P, Taglieri C, Russo C, et al. Minimally invasive approach for redo mitral valve surgery. J Thorac Dis. 2013. p. 686–93.
28.
Sündermann S, Czerny M, Falk V. Open vs. Minimally invasive mitral valve surgery: surgical technique, indications and results. Cardiovasc Eng Technol. 2015. p. 160–6.
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