Brazilian Journal of Cardiovascular Surgery
On-line version ISSN 1678-9741
DIAS, Ricardo Ribeiro et al. Aortic valve surgery: a prospective and randomized study of ministernotomy versus conventional surgery. Rev Bras Cir Cardiovasc [online]. 1999, vol.14, n.2, pp.98-104. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76381999000200005.
Objective: Minimally Invasive Surgery aims to provide a more rapid recovery, less time in hospital and intensive care unit (ICU), as well as less pain and cost, as a result of less surgical trauma to the patient. This clinical prospective and randomized study aims to evaluate the advantages of minimally invasive surgery of the aortic valve over the conventional one. Material and Methods: Forty consecutive patients were studied. All had Aortic Valve Disease, age of less than 80 years old and had not been submitted to previous surgery. The evaluation was made prospectively and randomized by computer into two groups (an inverted "L" ministernotomy and a conventional surgery group), during the period between June 1997 to August 1998. All patients were operated on according to pre-established surgical protocols. Both groups were clinically similar. The following variables were analyzed: incision size, ischemia, cardiopulmonary bypass (CPB) and surgical time, hospitalization and ICU time, time of extubation, bleeding, pain and mortality. The data were submitted to statistical analysis using the Student t Test, Mann Whitney Test and the Exact Fisher Test. Results: The group submitted to minimally invasive aortic valve replacement showed significantly increased time for ischemia and CPB than the conventional surgery group (p=0.006 and p=0.041, respectively) as well as a significantly smaller incision size (p<0.001). The other variables studied did not present any statistically significant differences. Conclusion: Better cosmetic effect through the minimally invasive surgery. Increased ischemia and CPB time were obtained in the ministernotomy group. The other results obtained for the two groups were similar.
Keywords : Aortic valve [surgery]; Surgical procedures [minimally invasive]; Prospective studies.