ArticleJournal of cardiothoracic surgery2019
Minimal invasive aortic valve replacement: associations of radiological assessments with procedure complexity.
Article in Journal of cardiothoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- CT-based evaluation of thoracic anatomy in AS vs AR patients undergoing MIAVR.General thoracic and cardiovascular surgery · 2026Article
- Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach.Journal of clinical medicine · 2023Article
- Advances in TEE-Centric Intraprocedural Multimodal Image Guidance for Congenital and Structural Heart Disease.Diagnostics (Basel, Switzerland) · 2023Review
- Anatomical circumstances and aortic cross-clamp time in minimally invasive aortic valve replacement.Interactive cardiovascular and thoracic surgery · 2021Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLimited aortic annulus exposure during minimal invasive aortic valve replacement (mini-AVR) proves to be challenging and contributes to procedure complexity, resulting in longer procedure times. New innovations like sutureless valves have been introduced to reduce procedure complexity. Additionally, preoperative imaging could also contribute to reducing procedure times. Therefore, we hypothesize that Computed Tomography (CT)-image based measurements are associated with mini-AVR complexity.
methodsOne hundred patients who underwent a mini-sternotomy and had a preoperative CT scan were included. With a CT-based mini-AVR planning tool, we measured access distance, access angle, annulus dimensions, and calcium volume. The associations of these measurements with cardiopulmonary bypass (CPB) time and aortic cross-clamp (AoX) time were assessed using univariable and multivariable regression models. In the multivariable models, these measurements were adjusted for age and suture technique.
resultsIn the univariable regression models, calcium volume and annulus dimensions were associated with longer CPB and AoX time. After adjusting for age and suture technique, increasing calcium volume was still associated with longer CPB (adjusted β-coefficient 0.002, 95%-CI (0.005, 0.019), p-value = 0.002) and AoX time (adjusted β-coefficient 0.010, 95%-CI (0.004, 0.016), p-value = 0.002). However, after adjusting for these confounders, the association between annulus dimensions and procedure times lost statistical significance.
conclusionIncrease in calcium volume are associated with longer CPB and AoX times, with age and sutureless valve implantation as independent confounders. In contrast to previous studies, access angle was not associated with procedure complexity.
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