Search

The article presents the authors' gratitude to guest editors of the periodical "Transplant International." It appreciates the significant contribution of the guest editors for their critical help in the editorial processing of the papers submitted at the 11th Congress of the European Society for Organ Transplantation in Venice, Italy in 2003. All of these papers underwent the full review process and were critically evaluated by the Guest Editors.

Objectives: Increasing experience with minimally invasive cardiac (MIC) aortic valve (AV) replacement makes AV reoperations (rAVR) an appealing alternative to conventional redo surgery. The aim of the study was to compare the perioperative outcome after isolated MIC versus full-sternotomy (FS) rAVR., Methods: We retrospectively analyzed data of 116 patients from three centers who underwent rAVR by using a FS ( n  = 70, 60.3%) or a partial upper sternotomy approach ( n  = 46, 39.7%). Both groups were compared in terms of 30-day mortality by using binary-logistic regression models. Further the EuroSCORE II was used to adjust for preoperative conditions in a multivariable model. Perioperative times and complications were compared between the two groups., Results: There was no statistically significant difference in perioperative mortality between FS ( n  = 5, 7.1%) and MIC ( n  = 1, 2.2%) rAVR in the original population (odds ratio [OR] 3.462, 95% confidence interval [CI] 0.391-30,635, p  = 0.264) and after adjusting for EuroSCORE II (OR 2.759, 95% CI 0.298-25.567, p  = 0.372). Cardiopulmonary bypass- (115.5 minutes vs. 137.5 minutes, p  = 0.070) and cross-clamp times (69.0 minutes vs. 81.0 minutes, p  = 0.028) were reduced in the MIC group. There was a lower prevalence of postoperative renal failure requiring renal replacement therapy (RRT) in the MIC group 0 and 8.6% ( p  = 0.041), respectively. No differences were detected between the groups regarding postoperative complications., Conclusion: MIC rAVR is associated with reduced cardiopulmonary and cross-clamp times as well as the need for RRT as compared with FS. MIC-rAVR seems to be a viable option in surgical candidates for AV reoperations., Competing Interests: None., (Georg Thieme Verlag KG Stuttgart · New York.)