Influence of cardiopulmonary bypass set-up and management on clinical outcomes after minimally invasive aortic valve surgery

Introduction: Minimally invasive aortic valve replacement (MIAVR) requires changes in cannulation strategy and cardiopulmonary bypass (CPB) management when compared to the conventional approach (CAVR). We aimed at evaluating if these differences could influence perfusion-related quality parameters a...

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Bibliographic Details
Published in:Perfusion 2021-10, Vol.36 (7), p.679-687
Main Authors: Cammertoni, Federico, Bruno, Piergiorgio, Pavone, Natalia, Farina, Piero, Mazza, Andrea, Iafrancesco, Mauro, Nesta, Marialisa, Chiariello, Giovanni A, Spalletta, Claudio, Cavaliere, Franco, Calabrese, Maria, D’Angelo, Gianluca A, Sanesi, Valerio, Conti, Francesco, D’Errico, Denise, Massetti, Massimo
Format: Article
Language:English
Subjects:
Aorta
Aortic valve
Aortic Valve - surgery
Blood pressure
Blood transfusion
Cannulation
Cardiopulmonary Bypass
Clinical outcomes
Complications
Flow velocity
Heart surgery
Heart Valve Prosthesis Implantation
Heart valves
Humans
Mechanical ventilation
Minimally Invasive Surgical Procedures
Parameters
Patients
Perfusion
Retrospective Studies
Transfusion
Treatment Outcome
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Summary:Introduction: Minimally invasive aortic valve replacement (MIAVR) requires changes in cannulation strategy and cardiopulmonary bypass (CPB) management when compared to the conventional approach (CAVR). We aimed at evaluating if these differences could influence perfusion-related quality parameters and impair postoperative outcomes. Methods: Overall, 339 consecutive patients underwent MIAVR or CAVR between 2014 and 2020 and were analyzed retrospectively. To account for baseline differences, a propensity-matching analysis was performed, obtaining two groups of 97 patients each. Results: MIAVR group had longer CPB time [107 (95–120) vs 95 (86–105) min, p = .003] than CAVR group. Of note, average pump flow rate index [2.4 (2.2–2.5) vs 2.7 (2.4–2.8) l/min/m2, p = .004] was lower in the MIAVR group. Mean arterial pressure was 73 = 9 mmHg vs 62 = 11 mmHg for the MIAVR and CAVR group, respectively (p 
ISSN:0267-6591
1477-111X
DOI:10.1177/02676591211023301