A Comparison Of The Minimally Invasive Right Third Intercostal Small Incision And Standard Aortic Valve Replacement

Objective:The safety and effectiveness of simple aortic valve replacement through a small incision in the third intercostal space of the right chest and a median sternum incision were compared and analyzed.Methods:Retrospective analysis of June 2013 to May2020,123 cases of patients with the first simple aortic valve replacement in Affiliated Hospital of Jining Medical College cardiac surgery.Among them,40 cases in the minimally invasive surgery group(the minimally invasive right third intercostal small incision)and 83 cases in the standard approach group(the middle section of the common sternum).The differences of the clinical data between the minimally invasive surgery group with the standard approach group.Results:The minimally invasive surgery group was 11female patients(27.5%),29 male patients(72.5%),54.60±9.98years,BMI 23.16±2.48kg/m~2,Aortic Stenosis(15 patients;37.5%),Aortic Regurgitation(17 patients;42.5%),Aortic Stenosis and Aortic Regurgitation(23 patients;11.2%),NYHA classⅡ(16 patients;40%),NYHA classⅢ(24 patients;60%).The standard approach group was 27 female patients(32.5%),56 male patients(67.5%),58.77±9.71 years,BMI 24.13±3.13kg/m~2,Aortic Stenosis(25 patients;30.1%),Aortic Regurgitation(30 patients;36.2%),Aortic Stenosis and Aortic Regurgitation(28 patients;33.7%),NYHA classⅡ(16 patients;40%),NYHA classⅢ(24 patients;60%).In the minimally invasive group,had significantly longer aortic cross-clamping times,cardiopulmonary bypass times and operation times(P<0.05),less blood loss(P<0.05),decreased less 24-hour chest drainage(P<0.05),decreased ventilator support times(P<0.05),less total expense(P<0.05).The minimally invasive group have shorter time of postoperative hospital stay(P>0.05),shorter time of ICU stay(P>0.05).Conclusion:Our series confirms that aortic valve replacement performed through the minimally invasive right third intercostal small incision is safely and effectively,with less blood loss,decreased 24-hour chest drainage,decreased ventilator support times,less invasive and better effect.