Thorac Cardiovasc Surg 2017; 65(03): 182-190
DOI: 10.1055/s-0036-1571827
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Respiratory System Function in Patients after Aortic Valve Replacement through Right Anterior Minithoracotomy

Jarosław Stoliński
1  Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital Jagiellonian University, Krakow, Poland
,
Dariusz Plicner
1  Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital Jagiellonian University, Krakow, Poland
,
Kamil Fijorek
2  Department of Statistics, Krakow University of Economics, Krakow, Poland
,
Grzegorz Grudzień
1  Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital Jagiellonian University, Krakow, Poland
,
Paweł Kruszec
1  Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital Jagiellonian University, Krakow, Poland
,
Janusz Andres
3  Department of Anesthesiology and Intensive Therapy, John Paul II Hospital Jagiellonian University, Krakow, Poland
,
Bogdan Kapelak
1  Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital Jagiellonian University, Krakow, Poland
› Author Affiliations
Further Information

Publication History

15 October 2015

22 December 2015

Publication Date:
23 February 2016 (online)

Abstract

Background The aim of the study was to analyze respiratory system function after minimally invasive aortic valve replacement through right anterior minithoracotomy (RAT-AVR).

Methods An observational study of 187 patients electively scheduled for RAT-AVR between January 2010 and December 2013. Pulmonary complications were analyzed and spirometry examinations were performed preoperatively, 1 week, 1 month, and 3 months after surgery.

Results Hospital mortality was 1.1%. A double-lumen intratracheal tube was used in 88.2% and single-lumen intratracheal tube was used in 11.8% of patients. Pulmonary complications occurred in 10.8% of the patients. Prolonged (>24 hours) mechanical ventilation time was present in five patients (2.7%). The reasons were stroke (n = 1), perioperative myocardial infarction (n = 2), and pneumothorax (n = 2). Right pleural effusion, which occurred in 7.7% (n = 14) of patients, was the most frequent respiratory system complication. One week after surgery, the spirometry parameters decreased in comparison to the preoperative period, then after 3 months statistically significant improvement occurred; however, the spirometry parameters still had not returned to preoperative values. Multivariable median regression analysis shows that the presence of chronic obstructive pulmonary disease and pulmonary complications were associated with lower values of forced expiratory volume in 1 second after surgery. There was no statistically significant difference regarding spirometry values or incidence of pulmonary complications after surgery between patients in whom single-lung or double-lung ventilation was applied.

Conclusion Pulmonary functional status measured with spirometry parameters was diminished after RAT-AVR surgery. Single-lung ventilation did not result in a higher rate of respiratory complications after RAT-AVR surgery.