Minimally Invasive Valvular Surgery in the Elderly ― Safety, Early Recovery, and Long-Term Outcomes ―
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- Hisatomi Kazuki
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Miura Takashi
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Obase Kikuko
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Matsumaru Ichiro
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Nakaji Shun
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Tanigawa Akihiko
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Taguchi Shunsuke
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Takura Masayuki
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Nakao Yuko
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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- Eishi Kiyoyuki
- Department of Cardiovascular Surgery, Nagasaki University Hospital
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抄録
<p>Background: For elderly people, the benefit of minimally invasive cardiac surgery (MICS) is unclear, so we evaluated the safety, recovery, and long-term survival in elderly MICS patients.</p><p>Methods and Results: 63 propensity score-matched pairs of 213 consecutive patients (≥70 years old) who underwent mitral and/or tricuspid valve surgery between 2010 and 2020 (121 right mini-thoracotomies vs. 92 full sternotomies) were compared. The primary outcome was safety (composite endpoint of in-hospital death or major complication). Secondary outcomes were early ambulation and discharge to home. There were no differences between the groups for in-hospital death (3.2% vs. 0.0%, P=0.157) and primary outcome (14.3% vs. 17.5%, P=0.617). The rate of early ambulation (73.0% vs. 55.6%, P=0.048) and discharge to home (66.7% vs. 49.2%, P=0.034) were significantly higher in the mini-thoracotomy group. Major complication was an independent negative predictor of early ambulation for mini-thoracotomy but not for a conservative approach. Survival was 87.8±4.4% vs. 86.8±4.7% at 5 years, which was not significantly different.</p><p>Conclusions: Similar safety but better recovery were observed for mini-thoracotomy, and long-term survival was comparable between groups. Major complication was a negative predictor of early ambulation after mini-thoracotomy. Careful preoperative risk stratification would enhance the benefits of MICS in elderly patients.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 86 (11), 1725-1732, 2022-10-25
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390012390812174720
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 032474674
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- PubMed
- 36198575
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
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- 抄録ライセンスフラグ
- 使用不可