[Pulmonary Complications after Minimally Invasive Aortic Valve Replacement Surgery - a Propensity Score Matching Analysis].

Instruction:To answer the questionif minimally invasive aortic valvereplacement surgery through a rightanterior minithoracotomy (RT-AVR)may result in increased incidence ofpostoperative pulmonary complicationscompared to conventional aorticvalve replacement through a mediansternotomy (AVR).Material and Methods:It was retrospectiveanalysis of 212 patientsscheduled for RT-AVR and 212 forAVR between January 2011 and December2014 selected with propensityscore matching. Respiratory systemcomplications are analysed.Results:Postoperative blooddrainage was 353±249 and 524±325ml in RT-AVR and AVR groups respectively(p<0.001). Hospital stay was5.7±1.6 and 8.5±4.3 days (p<0.001),ICU stay was 1.3±1.2 and 2.6±2.8 days(p<0.001) in RT-AVR and AVR patientsrespectively. Respiratory systemcomplications occurred in 13.7% ofRT-AVR patients and 17.0% of AVRpatients (p=0.364). Pneumonia was diagnosedin 2.4% and 0.5% of patients(p=0.129), pneumothorax in 2.0% and1.3% of patients (p=0.515), pleural effusionin 8.5% and 7.5% of patients(p =0.732) and thoracentesis wasperformed in 7.1% and 7.5% of patientsfrom RT-AVR and AVR groupsrespectively. Mediastinitis was diagnosedin 0.0% of RT-AVR and 2.8% ofAVR patients (p=0.020). Phrenic nervedysfunction was present in 3.8% ofRT-AVR and in 0.0% of AVR patients(p=0.006). COPD (OR=5.5; p<0.001)and increased postoperative bloodloss (OR=3.5; p<0.001) were risk factorsof postoperative pulmonary complications.Conclusion:Minimally invasiveRT-AVR surgery did not result in increasedrate of postoperative pulmonarycomplications compared toconventional AVR surgery througha median sternotomy.