Propensity score analysis of outcomes following minimal access versus conventional aortic valve replacement

This propensity matched single institution study compared conventional aortic valve replacement via a full sternotomy (CAVR) to minimal access aortic valve replacement (MAAVR) via an upper hemisternotomy. Over the eleven year study period a total of 2103 patients underwent isolated aortic valve replacement. After propensity matching, 585 patients were included in each group. Patient characteristics were well balanced between the two groups. There was no difference between the groups with respect to cross-clamp time although the MAAVR group had a longer average bypass time. The MAAVR group had a lower average volume of autologous blood transfusion, intubation time, post-operative renal complications and rate of respiratory insufficiency. There was no difference between the groups with regards to re-exploration for bleeding, ICU or hospital length of stay, early mortality of survival. The authors conclude that MAAVR is their procedure of choice for isolated aortic valve replacement.