Minimal access aortic surgery including re-operations

Objective: Safety and benefits of minimal access ascending aorta and aortic arch surgery, including for re-operations has not been reported. Methods: Fifty-four patients undergoing minimal access operations were evaluated. Of the 54 patients, valve replacements were performed in 76% (41 patients) (i ncluding composite valve grafts), and re-operations in 33% (18 patients). C omposite valve grafts were used in 28% (15 patients) patients, and elephant trunk type procedures in 6% (three patients). Results: The survival rate w as 96% (52 patients), stroke 3.7% (two patients), and neurocognitive defici t 1.8% (one patient). The circulatory arrest time was 20 min (SD 17), aorti c crossclamp time 91 min (SD 45) and cardiopulmonary bypass time 132 min (S D 59). Intraoperative homologous blood transfusion was a mean of 1.3 units (SD 2.3). ICU and postoperative stay were 1.8 days (SD 1.9) and 6.7 days (S D 3.7), respectively. No patient died after reoperation, although one patie nt had a stroke. Conclusions: Minimal access aortic surgery does not appear to carry a greater risk and, although more demanding technically, is assoc iated with a reasonable ICU and hospital stay. For re-operations, we partic ularly recommend the technique. (C) 2001 Elsevier Science B.V. All rights r eserved.