Recambio valvular aórtico aislado en pacientes mayores de 75 años mediante abordaje mínimamente invasivo y bioprótesis sin sutura

Abstract

Introduction Study on the influence of sutureless aortic valvular bioprosthesis on the postoperative inflammatory response and on the clinical impact following the implementation of a minimally invasive surgery program (MIS) using sutureless bioprosthesis. Methods Preliminary phase: Randomized clinical trial. Group P (sutureless bioprosthesis through CMI, n = 20), Group C (conventional bioprosthesis through MIS, n = 20). Determination of biomarkers of inflammatory response were obtained. Sutureless-MIS program assessment: Restrospective study. Group A: Sutureless bioprosthesis through MIS (n = 108). Group B: Conventional bioprosthesis through full sternotomy (n = 115). Results Preliminary phase: Randomized clinical trial. Group P (sutureless bioprosthesis through CMI, n = 20), Group C (conventional bioprosthesis through MIS, n = 20). Determination of biomarkers of inflammatory response were obtained. Sutureless-MIS program assessment: Restrospective study. Group A: Sutureless bioprosthesis through MIS (n = 108). Group B: Conventional bioprosthesis through full sternotomy (n = 115). Results Preliminary phase: Reduction of surgical times in Group P versus group C, associated with lower postoperative levels of IL-6 (p = 0.021). Sutureless-MIS program assessment: Perioperative mortality was 1/223 patients, belonging to group B. Surgical times, ICU and hospital stays, transfusional requirements and postoperative aortic valve gradients were lower in group A (p < 0.05). Group A showed a higher rate of pacemaker implantation (p = 0.051). Conclusion The MIS using sutureless aortic bioprosthesis allowed a significant reduction in surgical times associated with lower levels of IL-6 and was shown as a safe and effective technique, providing clinical benefits when compared to conventional surgery.