Abstract
Background: With the promotion of minimally invasive concepts and
advances in total thoracoscopic valve surgery, total thoracoscopic
aortic valve surgery has become a new option for patients with aortic
valve lesions. However, due to its anatomical characteristics, poor
surgical field exposure and limited operating space, only a few centers
have performed further studies on this procedure. Methods: We evaluate
the safety and advantages of total thoracoscopic aortic valve
replacement compared to the upper mini-sternotomy AVR group and the
conventional AVR group with important perioperative data as well as
early postoperative outcomes. Results: All patients successfully
underwent elective surgery, with no intraoperative conversion or death
occurring. Patients in the total thoracoscopy group had significantly
prolonged CPB and aortic clamping (AC) times compared to the other two
groups. The average Postoperative chest drainage in the first 24 h of
the total thoracoscopic group was significantly less than the other two
groups. The mean VAS pain score in the total thoracoscopic group was
significantly less than the other two groups. In addition, the total
thoracoscopic group had a significantly decreased ICU stay as well as
the total hospital stay. Although the length of mechanical ventilation
between groups did not show statistically significant differences,
mechanical ventilation in the total thoracoscopy group had a smaller
relative number. Conclusions: Despite the need for improvement, total
thoracoscopic aortic valve replacement is safe, and may improve clinical
outcome