Thorac Cardiovasc Surg 2014; 62(01): 042-046
DOI: 10.1055/s-0033-1349354
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Versus Conventional Extracorporeal Circulation in Minimally Invasive Cardiac Valve Surgery

Hardy Baumbach
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
,
Christian Rustenbach
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
,
Jens Michaelsen
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
,
Gernot Hipp
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
,
Markus Pressmar
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
,
Marco Leinweber
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
,
Ulrich Friedrich Wilhelm Franke
1   Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
› Author Affiliations
Further Information

Publication History

24 February 2013

07 June 2013

Publication Date:
23 July 2013 (online)

Abstract

Background Minimally invasive extracorporeal circulation (MECC) technology was applied predominantly in coronary surgery. Data regarding the application of MECC in minimally invasive valve surgery are missing largely.

Patients and Methods Patients undergoing isolated minimally invasive mitral or aortic valve procedures were allocated either to conventional extracorporeal circulation (CECC) group (n = 63) or MECC group (n = 105), and their prospectively generated data were analyzed.

Results Demographic data were comparable between the groups regarding age (CECC vs. MECC: 71.0 ± 7.5 vs. 66.2 ± 10.1 years, p = 0.091) and logistic EuroSCORE I (6.2 ± 2.5 vs. 5.4 ± 3.0, p = 0.707). Hospital mortality was one patient in each group (1.6 vs. 1.0%, p = 0.688). The levels of leukocytes were lower in the MECC group (11.6 ± 3.2 vs. 9.4 ± 4.3 109/L, p = 0.040). Levels of platelets (137.2 ± 45.5 vs. 152.4 ± 50.3 109/L, p = 0.015) and hemoglobin (103.3 ± 11.3 vs. 107.3 ± 14.7 g/L, p = 0.017) were higher in the MECC group. Renal function was better preserved (creatinine: 1.1 ± 0.4 vs. 0.9 ± 0.2 mg/dL, p = 0.019). We were able to validate shorter time of postoperative ventilation (9.5 ± 15.1 vs. 6.3 ± 3.4 h, p = 0.054) as well as significantly shorter intensive care unit (ICU) stay (1.8 ± 1.3 vs. 1.2 ± 1.0 d, p = 0.005) for MECC patients. The course of C-reactive protein did not differ between the groups.

Conclusion We were able to prove the feasibility of MECC even in minimally invasive performed mitral and aortic valve procedures. In addition, the use of MECC provides decreased platelet consumption and less hemodilution. The use of MECC in these selected patients lead to a shorter ventilation time and ICU stay.

Note

Data were presented in part at the 26th Annual Meeting of the European Association for Cardio-Thoracic Surgery, Barcelona, Spain.


 
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