The Analysis Of Minimally Invasive Incision And Conventional Median Sternotomy In The Surgical Approach Of Aortic Valve Replacement Operation

BackgroundTraditional median sternotomy aortic valve replacement surgery has been widely used in clinical. In recent years, minimally invasive incision aortic valve replacement surgery, brought to the patient with less trauma, rapid recovery, less pain, incision hidden beauty, has gradually been recognized by cardiac surgeons.ObjectivesBy reviewing and summarizing the clinical date of minimally invasive incision aortic valve replacement surgery, compared to that of the median thoracotomy aortic valve replacement surgery, we aim to analyze and make an objective evaluation of minimally invasive incision aortic valve replacement surgery.Materials and MethodsFrom September 2013 to September 2015, the clinic date of 62 patients who underwent aortic valve replacement surgery in the cardiology surgery department of Shandong University affiliated Shandong Qianfoshan Hospital were analyzed retrospectively. They were divided into minimally invasive group(24 cases)and traditional group(38 cases). The patients included in retrospevtive research groups were under 75 years old, NYHA class was II or III. Coronary angiography is required for patients over 50 years old to rule out the coronary artery disease. After the operation, the clinical data of both groups were collected, and analyzed by using statistical software.ResultsBoth groups of patients were successful completed surgery, no death cases, no complications after surgery. In operation time, cardiopulmonary bypass time and aortic cross-clamp time, minimally invasive group had no significant difference with traditional group; However, in intraoperative blood transfusion and postoperative 24 hours drainage volume, minimally invasive group was significantly less than that of traditional group; in mechanical ventilation time, postoperative ICU monitoring time and postoperative hospitalization time, minimally invasive group was significant shorter than that of traditional group; the incisive length of minimally invasive incision group were shorter.On the fourth day after operation, the patients were asked to use numeric rating scales(NRS) to score the degree of pain in surgical incision and adjacent area. The score of minimally invasive group was significantly lower than that of traditional group. One week after operation, all patients were reviewed by echocardiograph, and the function of aortic valve was good, without perivalvular leakage observed. All patients were followed up for 3 to 12 months. The clinical symptoms were significant improved, NYHA class was I or II, and the quality of life was significant higher than that before operation.ConclusionsThe minimally invasive aortic valve replacement surgery is safety and effective, with less trauma, rapid recovery, less pain, shorter hospital stay, incision hidden beauty compared with the conventional median thoracotomy surgery, it is worth popularizing in clinic.