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Article Type

Original Study

Abstract

Objectives The aim of this study is to evaluate the outcome of the recalled upper minimally invasive aortic valve replacement (MIAVR) J-shaped technique and full standard median sternotomy techniques aortic valve replacement (AVR). Background Over the past 20 years, MIAVR has evolved into a safe, well-tolerated, and efficient surgical treatment option for aortic valve disease. It has been shown to reduce postoperative morbidity, providing faster recovery and rehabilitation, shorter hospital stays, and better cosmetic results, as it reduces the incidences of wound infection owing to small incision length, especially in our diabetic fatty Egyptian female patients. Patients and methods Between September 2017 and March 2019, this study included 50 patients with isolated aortic valve disease. A total of 25 patients (group A) underwent (MIAVR) J-shaped technique and 25 patients (group B) underwent standard AVR, and they were compared with each other. Results In operative data, there were highly significant differences between both groups regarding aortic cross-clamp time, total bypass time, and total operative time (P < 0.001). In postoperative data, there were highly significant differences regarding total hospital stay, pain score in the first, second, third, and fourth day to hospital discharge; and patient satisfaction (P < 0.001). There was a significant difference in duration of ICU stay (P = 0.033). There were no mortalities in both groups. Conclusion MIAVR is a feasible procedure despite the narrow operative field that induced long operative times. It is safe with minimal postoperative morbidities, early rehabilitation, and less postoperative pain. Moreover, MIAVR provided cosmetically better wound results, which was immensely satisfying to the patients.

Keywords

Aortic valve replacement, minimally invasive aortic valve surgery, ministernotomy

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