Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach
Introduction. The most common minimally invasive approach for aortic valve replacement (AVR) is the partial upper mini-sternotomy. The aim of this study is to understand which preoperative computed tomography (CT) features are predictive of longer operations in terms of cardio-pulmonary bypass times...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/21/6717 |
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| author | Francesco Giosuè Irace Ilaria Chirichilli Marco Russo Federico Ranocchi Marcello Bergonzini Antonio Lio Francesca Nicolò Francesco Musumeci |
| author_facet | Francesco Giosuè Irace Ilaria Chirichilli Marco Russo Federico Ranocchi Marcello Bergonzini Antonio Lio Francesca Nicolò Francesco Musumeci |
| author_sort | Francesco Giosuè Irace |
| collection | DOAJ |
| description | Introduction. The most common minimally invasive approach for aortic valve replacement (AVR) is the partial upper mini-sternotomy. The aim of this study is to understand which preoperative computed tomography (CT) features are predictive of longer operations in terms of cardio-pulmonary bypass timesand cross-clamp times. Methods. From 2011 to 2022, we retrospectively selected 246 patients which underwent isolated AVR and had a preoperative ECG-gated CT scan. On these patients, we analysed the baseline anthropometric characteristics and the following CT scan parameters: aortic annular dimensions, valve calcium score, ascending aorta length, ascending aorta inclination and aorta–sternum distance. Results. We identified augmented body surface area (>1.9 m<sup>2</sup>), augmented annular diameter (>23 mm), high calcium score (>2500 Agatson score) and increased aorta–sternum distance (>30 mm) as independent predictors of elongated operation times (more than two-fold). Conclusions. Identifying the preoperative predictive factors of longer operations can help surgeons select cases suitable for minimally invasive approaches, especially in a teaching context. |
| first_indexed | 2024-03-11T11:27:46Z |
| format | Article |
| id | doaj.art-c8b36d39f0b74396a334144a73109349 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T11:27:46Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c8b36d39f0b74396a334144a731093492023-11-10T15:06:12ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011221671710.3390/jcm12216717Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy ApproachFrancesco Giosuè Irace0Ilaria Chirichilli1Marco Russo2Federico Ranocchi3Marcello Bergonzini4Antonio Lio5Francesca Nicolò6Francesco Musumeci7Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyDepartment of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, Viale Gianicolense 87, 00151 Rome, ItalyIntroduction. The most common minimally invasive approach for aortic valve replacement (AVR) is the partial upper mini-sternotomy. The aim of this study is to understand which preoperative computed tomography (CT) features are predictive of longer operations in terms of cardio-pulmonary bypass timesand cross-clamp times. Methods. From 2011 to 2022, we retrospectively selected 246 patients which underwent isolated AVR and had a preoperative ECG-gated CT scan. On these patients, we analysed the baseline anthropometric characteristics and the following CT scan parameters: aortic annular dimensions, valve calcium score, ascending aorta length, ascending aorta inclination and aorta–sternum distance. Results. We identified augmented body surface area (>1.9 m<sup>2</sup>), augmented annular diameter (>23 mm), high calcium score (>2500 Agatson score) and increased aorta–sternum distance (>30 mm) as independent predictors of elongated operation times (more than two-fold). Conclusions. Identifying the preoperative predictive factors of longer operations can help surgeons select cases suitable for minimally invasive approaches, especially in a teaching context.https://www.mdpi.com/2077-0383/12/21/6717aortic valveaortic valve replacementminimally invasive cardiac surgerycomputed tomography |
| spellingShingle | Francesco Giosuè Irace Ilaria Chirichilli Marco Russo Federico Ranocchi Marcello Bergonzini Antonio Lio Francesca Nicolò Francesco Musumeci Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach Journal of Clinical Medicine aortic valve aortic valve replacement minimally invasive cardiac surgery computed tomography |
| title | Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach |
| title_full | Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach |
| title_fullStr | Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach |
| title_full_unstemmed | Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach |
| title_short | Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach |
| title_sort | aortic valve replacement understanding predictors for the optimal ministernotomy approach |
| topic | aortic valve aortic valve replacement minimally invasive cardiac surgery computed tomography |
| url | https://www.mdpi.com/2077-0383/12/21/6717 |
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