Comparison between mini-access and median sternotomy for aortic valve replacement: propensity score matching analysis

Enginoev S.T.; Magomedov G.M.; Zenkov A.A.; Smagilaev T.M.; Guliev M.A.; Chernov I.I.

doi:https://doi.org/10.17116/kardio202417061617

Enginoev S.T.

Federal Center for Cardiovascular Surgery;
Astrakhan State Medical University

ORCID: 0000-0002-8376-3104

Magomedov G.M.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-1278-9278

Zenkov A.A.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-7119-2340

Smagilaev T.M.

Astrakhan State Medical University

ORCID: 0009-0002-4213-5854

Guliev M.A.

Astrakhan State Medical University

ORCID: 0000-0002-9503-5323

Chernov I.I.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-9924-5125

Comparison between mini-access and median sternotomy for aortic valve replacement: propensity score matching analysis

Authors:

Enginoev S.T., Magomedov G.M., Zenkov A.A., Smagilaev T.M., Guliev M.A., Chernov I.I.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(6): 617‑623

DOI: 10.17116/kardio202417061617

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To cite this article:

Enginoev ST, Magomedov GM, Zenkov AA, Smagilaev TM, Guliev MA, Chernov II. Comparison between mini-access and median sternotomy for aortic valve replacement: propensity score matching analysis. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(6):617‑623. (In Russ.)
https://doi.org/10.17116/kardio202417061617

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To compare the immediate and long-term results of sternotomy and mini-approach for aortic valve replacement.

MATERIAL AND METHODS

A retrospective study included 718 patients who underwent isolated aortic valve replacement between April 2009 and December 2019. Propensity score matching was performed due to significant differences in clinical and demographic parameters. Two groups were distinguished: group I (sternotomy) — 67 patients, group II (mini-access) — 67 patients. Inclusion criteria: isolated aortic valve replacement, age ≥18 years. Exclusion criteria: Ross procedure, AVNeo, combined interventions, left ventricular ejection fraction≤40%, repeated interventions. The median follow-up period was 44 (7—80) months.

RESULTS

Duration of surgery, cardiopulmonary bypass and myocardial ischemia was similar in both groups (155 versus 165 min, p=0.4; 87 versus 92 min, p=0.4; 68 versus 70 min, p=0.4). There was no in-hospital mortality, stroke or perioperative myocardial injury. No significant difference was found in postoperative complications and length of ICU- and hospital-stay. Incidence of explorations for bleeding (3% vs 1.5%, p=0.9), pacemaker implantation (3% vs 1.5%, p=0.9), acute kidney injury (1.5% vs 0%, p=0.9) and sternal infection (0% vs 1.5%, p=0.9) was similar. One, 3-, 5- and 9-year survival was 100%, 100%, 94.7% and 81.5% after sternotomy, 100%, 91.1%, 85.9% and 85.9% after mini-access (p=0.34). Nine-year freedom from redo surgeries was 92% and 97%, respectively (p=0.84).

CONCLUSION

There was no significant difference in immediate and long-term results.

Keywords:

aortic valve

valve replacement

mini-access

sternotomy

Authors:

Enginoev S.T.

Federal Center for Cardiovascular Surgery;
Astrakhan State Medical University

ORCID: 0000-0002-8376-3104

Magomedov G.M.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-1278-9278

Zenkov A.A.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-7119-2340

Smagilaev T.M.

Astrakhan State Medical University

ORCID: 0009-0002-4213-5854

Guliev M.A.

Astrakhan State Medical University

ORCID: 0000-0002-9503-5323

Chernov I.I.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-9924-5125

Received:

20.04.2023

Accepted:

10.07.2023

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