Therefore, our study aimed to analyze the effect of MIVS on the incidence of PPCs in patients undergoing isolated mitral or aortic valve surgery. To the best of our knowledge, no previous clinical study has directly compared the incidence of pulmonary complications among matched groups after minimally invasive valve surgery vs.
#Propensity score matching spss version 25 full
Whereas the association between full median sternotomy surgery and development of postoperative pulmonary complications has been widely established, however there is still ongoing debate about the effect of MIVS on postoperative pulmonary complications (PPCs), and the associations remain unclear. The most common pulmonary complications include atelectasis and pleural effusions, pneumonia, pneumothorax, diaphragm paralysis due to phrenic nerve injury, and pulmonary infection. These complications contribute to longer hospital stays and more readmissions into the ICU, significantly affecting health care and increasing the financial burden to health care systems. Despite such improvements in surgical management and patients’ care over the years, however, pulmonary complications remain a leading cause of morbidity and mortality after cardiac surgery. These findings, along with a decrease in-hospital mortality in elderly patients, lead to an increase in the acceptance of minimally invasive valve surgery as an alternative to traditional full median sternotomy surgery in many centers worldwide. The technique of minimally invasive valve surgery (MIVS) was introduced to reduce surgical trauma and bleeding, decrease postoperative pain, and promote earlier discharge and quicker postoperative recovery. However, minimally invasive surgery has been undergoing rapid development in the last few decades. The full sternotomy approach has been the gold standard for cardiac valve repair or replacement for many years, and most cardiac surgical centers continue to use it because it allows excellent exposure of the heart and great vessels. MIVS for isolated valve surgery reduces the risk of PPCs compared with the FS approach.
A multivariable analysis revealed a decreased risk of PPCs in patients undergoing MIVS (odds ratio, 0.25 95% confidence interval, 0.006–0.180 P < 0.0001). Cardiopulmonary bypass (CBP), aortic cross-clamping, and operative time intervals were significantly longer in the MIVS group than in the matched FS group ( P < 0.001). 69%, respectively P 24 h) ( P = 0.016), blood transfusion amount ( P = 0.006), length of hospital stay ( P < 0.0001), and ICU stay ( P < 0.0001) were significantly less in the MIVS group. The incidence of PPCs was significantly less in the MIVS group than in the FS group (19% vs. Propensity score matching revealed no significant difference in hospital mortality between the groups. Propensity score-matching analysis was used to compare outcomes between the groups and to reduce selection bias. We reviewed the records of 1076 patients who underwent isolated mitral or aortic valve surgery (80 MIVS and 996 FS) in our institution between January 2015 and December 2019. Our study aims to analyze whether minimally invasive valve surgery (MIVS) can reduce the incidence of postoperative pulmonary complications compared to the full median sternotomy (FS) approach. Postoperative pulmonary complications (PPCs) are common incidents associated with an increased hospital stay, readmissions into the intensive care unit (ICU), increased costs, and mortality after cardiac surgery.