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Canadian Journal of Cardiology

Minimally Invasive Heart Valve Surgery

  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Ismail Bouhout
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    Department of Cardiovascular Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
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  • Author Footnotes
    ∗ These authors contributed equally to this work.
    Marie-Catherine Morgant
    Footnotes
    ∗ These authors contributed equally to this work.
    Affiliations
    Department of Cardiovascular Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
    Search for articles by this author
  • Denis Bouchard
    Correspondence
    Corresponding author: Dr Denis Bouchard, 5000 Belanger St, Montréal, Québec, Canada, H1T 1C8. Tel.: +1-514-376-3330; fax: +1-514-593-2157.
    Affiliations
    Department of Cardiovascular Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to this work.

      Abstract

      Minimally invasive valve surgery represents a recent and significant advance in modern heart surgery. Indeed, many less invasive approaches for both the aortic and mitral valves have been developed in the past 2 decades. These procedures were hypothesized to result in less operative trauma, which might translate into better patient outcomes. However, this clinical benefit remains controversial in the literature. The aim of this review is to discuss the evidence surrounding minimally invasive heart valve surgery in the current era. A systematic search of the literature from 2006-2016 was performed looking for articles reporting early or late outcomes after minimally invasive valve surgery. Less invasive valve surgery is safe and provides long-term surgical outcomes similar to those of standard sternotomy. In addition, these approaches result in a reduction in overall hospital length of stay and may mitigate the risk of early morbidity—mainly postoperative bleeding, transfusions, and ventilation duration.

      Résumé

      La chirurgie minimalement invasive des valves cardiaques est une avancée récente et importante de la chirurgie cardiaque moderne. En effet, de nombreuses approches moins invasives qu’auparavant ont été mises au point pour les valves aortiques et mitrales au cours des deux dernières décennies. L’hypothèse était que ces interventions entraîneraient moins de traumatismes opératoires, et donc de meilleurs résultats pour les patients. Cependant, ces bienfaits cliniques demeurent matière à controverse dans la littérature. L'objectif de cette revue de la littérature est d’examiner les données probantes entourant les chirurgies minimalement invasive des valves cardiaques pratiquées à l'ère actuelle. Une recherche systématique de la littérature entre 2006 et 2016 a été effectuée en examinant les articles présentant les résultats précoces ou tardifs de chirurgies minimalement invasive des valves cardiaques. La chirurgie moins invasive des valves cardiaques est sécuritaire et fournit des résultats chirurgicaux à long terme semblables à ceux de la sternotomie habituelle. En outre, ces approches sont associées à une durée globale du séjour à l'hôpital réduite et peuvent atténuer le risque de morbidité précoce, principalement en diminuant le risque de saignements postopératoires et de transfusions et en raccourcissant la durée de la ventilation.
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