Objective : To determine the advantages and/or risks of minimally invasive aortic valve replacement compared to standard sternotomy procedure.
Methods : From January 1997 to December 2001, 271 consecutive adult patients underwent isolated aortic valve replacement of which 174 underwent a minimally invasive procedure (Group 1) and 97 a standard procedure (Group 2). The preoperative variables of both groups were comparable. We retrospectively analysed operative outcome of both groups.
Results : Follow up was complete and ranged from 6 months to 3 years. Overall in-hospital mortality was 3,3% (respectively 2,8 and 4,1%). Statistical analysis failed to show differences between groups in mortality rate, valve size and type, operative time variables and hospital stay. Nevertheless there was a significant higher incidence of revision for post-operative bleeding or early tamponade (p=0.018), as well as late pericardial effusion (p=0.022) in the minimal invasive group. Also trends were in favour of Group 2 for incidence of post-operative pneumothorax and pericarditis constructiva.
Conclusion : Minimal invasive aortic valve replacement is a safe and reliable procedure but carries an incision-related morbidity which was constant over the study period..Proper patient selection is mandatory, and the only proven benefit seems esthetic.