Aortic valve replacement by mini-j sternotomy in patient with BMI more than 31
Abstract
The aim of our study was a retrospective evaluate of effective and safety aortic valve replacement by Mini-J sternotomy in patient with body mass index more than 31.
Methods: Between October 2012 to April 2023, in our Center was performed 660 operations - isolated aortic valve replacement. Mini-J sternotomy approach for AVR performed in 212 cases. In 135 cases we diagnostic BMI more then 31, in 50 cases from this BMI was wore then 35. Additionally, for comparison, we formed a group of patients who underwent aortic valve replacement by standard approach. Mean EuroScore II was 2.6 ± 0.5%.
Results: Hospital mortality and operations relation complications such as: complete atrioventricular block, interventricular septal defect not differ in researched groups (p = 0.242, p = 0.191 and p = 1.0). Blood transfusions and resternotomies were performed significantly more in group of standard access (p = 0.007 and p = 0.024). Operating time was statistically longer in mini-J sternotomy, but without a significant differ in CPB time (p < 0.001 and p = 0.729). Mean follow-up period for groups mini-J sternotomy with BMI ≥ 31 and standard approach was 61.1 months (95% CI 51.6 -66.4) and 62.1 months (95% CI 54.6 -67.4) , respectively. Survival rates at 12.36 and 60 months were 99.2%, 94.4%, 89.3% and 92.7%, 94.8%, 87.3% (Logrank test = 0.745). Freedom from thromboembolic complications at 12.36 and 60 months was 100%, 95.5%, 92.3% and 100%, 95.6%, 88.4% (Log-rank test = 0.745).
Conclusion: Applying mini-J sternotomy in patients with BMI more then 31 for surgical treatment of aortic valve, allows effective and safe treatment of this group patients and shows good immediate and long-term results.
About the Authors
Yu. A. Schneider
Federal State Budgetary Institution «Federal Сenters of High Medical Technologies» Health Ministry
Russian Federation
Russian Federation
Schneider Yuri Alexandrovich - Dr. Med. Sc., professor, laureate of Burakovsky V.I. awards for achievements in the cardiac surgery, Honored Doctor of Russia, Chief Doctor
Kaliningrad, 236035, 4 Kaliningradskoe HW, settl. Rodniki, Guryevsky district, Kaliningrad region
tel. 8 (4012) 592 000, fax 8 (4012) 592 198
M. D. Tsoi
Federal State Budgetary Institution «Federal Сenters of High Medical Technologies» Health Ministry
Russian Federation
Russian Federation
Tsoi Victor Gennadievich - proxy Chief Doctor by Surgery, Chief of Cardiac Surgery Department №1
Kaliningrad, 236035, 4 Kaliningradskoe HW, settl. Rodniki, Guryevsky district, Kaliningrad region
tel. 8 (4012) 592 000, fax 8 (4012) 592 198
M. S. Fomenko
Federal State Budgetary Institution «Federal Сenters of High Medical Technologies» Health Ministry
Russian Federation
Russian Federation
Fomenko Mikhail Sergeevich - Cand. Med. Sc., Сardiovascular surgeon of the cardiac surgery department №1
Kaliningrad, 236035, 4 Kaliningradskoe HW, settl. Rodniki, Guryevsky district, Kaliningrad region
tel. 8 (4012) 592 000, fax 8 (4012) 592 198
A. A. Pavlov
Federal State Budgetary Institution «Federal Сenters of High Medical Technologies» Health Ministry
Russian Federation
Russian Federation
Pavlov Alexander Anatolyevich - Cardiovascular surgeon of the cardiac surgery department № 1
Kaliningrad, 236035, 4 Kaliningradskoe HW, settl. Rodniki, Guryevsky district, Kaliningrad region
tel. 8 (4012) 592 000, fax 8 (4012) 592 198
P. A. Shilenko
Federal State Budgetary Institution «Federal Сenters of High Medical Technologies» Health Ministry
Russian Federation
Russian Federation
Shilenko Pavel Alexandrovich - Сardiovascular surgeon of the cardiac surgery department №1
Kaliningrad, 236035, 4 Kaliningradskoe HW, settl. Rodniki, Guryevsky district, Kaliningrad region
tel. 8 (4012) 592 000, fax 8 (4012) 592 198
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Review
For citations:
Schneider Yu.A., Tsoi M.D., Fomenko M.S., Pavlov A.A., Shilenko P.A. Aortic valve replacement by mini-j sternotomy in patient with BMI more than 31. Minimally Invasive Cardiovascular Surgery. 2024;3(1):57-67. (In Russ.)
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