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The benefit of fibrosa layer stripping technique during minimally invasive aortic valve replacement for calcified aortic valve stenosis ---A randomized controlled trial
  • +2
  • Yuan Zhou,
  • Liang Zhang,
  • Kun Hua,
  • Jinwei Zhang,
  • Xiubin Yang
Yuan Zhou
Capital Medical University Affiliated Anzhen Hospital
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Liang Zhang
Capital Medical University Affiliated Anzhen Hospital
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Kun Hua
Capital Medical University Affiliated Anzhen Hospital
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Jinwei Zhang
Capital Medical University Affiliated Anzhen Hospital
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Xiubin Yang
Capital Medical University Affiliated Anzhen Hospital
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Peer review status:UNDER REVIEW

31 Jul 2020Submitted to Journal of Cardiac Surgery
31 Jul 2020Assigned to Editor
31 Jul 2020Submission Checks Completed
03 Aug 2020Reviewer(s) Assigned

Abstract

Background: Fibrosa layer stripping (FLS) technique is a new approach to remove calcified aortic valve. In this study, we aimed to assess the effectiveness of the FLS technique by comparing with the conventional technique in minimally invasive aortic valve replacement (MIAVR). Methods: A prospective, single-center, randomized controlled trial was conducted at Beijing Anzhen Hospital. 70 patients diagnosed with severe calcific aortic stenosis were randomly assigned to undergo FLS (n=35) or conventional (n=35) technique to debride calcified aortic valve. Preoperative profile, procedural parameters, and postoperative outcomes were analyzed. Results: No significant difference was observed in the preoperative profile between two groups. Compared with the conventional technique, the FLS technique had significantly higher indexed effective orifice area and lower mean gradient. Moreover, FLS technique was associated with significantly reduced aortic cross-clamp time (41[38-44] vs 56[51-60] min, p<0.001), cardiopulmonary bypass (CPB) time (63[56-69] vs 81[75-84] min, p<0.001) and operative time (148[141-156] vs 173[169-180] min, p<0.001). Lastly, the length of intensive care unit stay (1.2±0.4 vs 1.5±0.8 days, p=0.041) and hospital stay (5.3±0.6 vs 6.0±1.4 days, p=0.020) was significantly reduced in the FLS group compared with those in the conventional group. Conclusions: FLS technique is effective in removing calcified tissue during MIAVR and is associated with shorter cross-clamp time and CPB time, and better hemodynamic performance than conventional technique.