Grant: Travel Awards - Institute Community Support

What was the aim of this study? We wanted to see if using a smaller cut to replace the diseased aortic valve has similar outcomes to valve replacement by the traditional approach. What was the question? The aortic valve prevents blood from flowing backwards into the heart. A diseased aortic valve needs to be surgically replaced to avoid fatal consequences such as heart failure and sudden death. The standard surgery is done by completely cutting the breastbone open to gain access to the heart and replace the valve. However, this results in a large and painful incision. The proposed surgical technique uses only a small cut to replace the damaged valve and prevents the complete cutting of the breastbone. While this approach makes the operation more challenging to perform, it could have several advantages such as decreased bleeding and faster recovery. What was done in this study? We evaluated the Cardiac Service BC database to compare all isolated aortic valve replacements performed in our institution from Jan 2007 to Dec 2016. Nine hundred ten patients were identified (776 undergoing standard surgery and 134 undergoing surgery with the small cut) with a median follow-up of 6.2 years. What did we find? We found no difference in the number of deaths between the two groups both during 30 days post-surgery and in the long term. Patients undergoing surgery using the small cut were put on a heart-lung machine for a shorter duration during the surgery compared to the standard group. Similarly, the amount of time that the aortic artery needed to be closed was shorter with the small-cut surgery. Small-cut surgery patients were discharged home earlier after the operation. There was no difference between the two groups in the prevalence of irregular heart rhythms or kidney problems after surgery. What do we conclude? The smaller incision surgery is a safe and effective alternative to standard surgery and provides similar survival outcomes.