{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:24:47Z","timestamp":1789691087932,"version":"4.0.1"},"reference-count":14,"publisher":"Texas Heart Institute Journal","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantation in low-risk patients. In this light, we evaluated the safety and effectiveness of SAVR performed through conventional and less invasive surgical approaches in a high-volume center.<\/jats:p>\n        <jats:p>We retrospectively reviewed the records of 395 consecutive patients who underwent open SAVR from January 2019 through December 2019 in our center. We evaluated and compared the operative results and postoperative major adverse outcomes of 3 surgical approaches: full median sternotomy (n=267), upper ministernotomy (ministernotomy) (n=106), and right anterior thoracotomy (minithoracotomy) (n=22).<\/jats:p>\n        <jats:p>Overall, the 30-day all-cause mortality rate was 0.8% (3 patients). Stroke occurred in 8 patients (2%), disabling stroke in 4 patients (1%), myocardial infarction in 1 (0.2%), and surgical site infection in 13 (3.2%). There was no difference in 30-day mortality rate or incidence of postoperative major adverse events among the 3 surgical groups. Stroke and surgical site infection occurred more frequently, but not significantly so, in the full-sternotomy group. The mean hospital stay was longer after full sternotomy (9.1 \u00b1 5.5 d) than after ministernotomy (7.5 \u00b1 2.9 d) or minithoracotomy (7.4 \u00b1 1.9 d) (<jats:italic>P<\/jats:italic>=0.012).<\/jats:p>\n        <jats:p>Our findings suggest that open SAVR performed in a high-volume center is associated with a low early mortality rate and that less invasive approaches result in faster postoperative recovery and shorter hospital stays.<\/jats:p>","DOI":"10.14503\/thij-20-7435","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T14:57:34Z","timestamp":1643641054000},"source":"Crossref","is-referenced-by-count":2,"title":["Low-Risk Surgical Aortic Valve Replacement in the Era of Transcatheter Aortic Valve Implantation"],"prefix":"10.14503","volume":"49","author":[{"given":"Milos M.","family":"Jovanovic","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slobodan V.","family":"Micovic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miodrag S.","family":"Peric","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor S.","family":"Zivkovic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stasa D.","family":"Krasic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mother and Child Health Care Institute of Serbia, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ognjen S.","family":"Milicevic","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan P.","family":"Stankovic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar M.","family":"Vukovic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5628","reference":[{"issue":"36","key":"i1526-6702-49-1-e207435-b1","series-title":"Eur Heart J","first-page":"2739","article-title":"ESC\/EACTS guidelines for the management of valvular heart disease [published erratum appears in Eur Heart J 2018;39(21):1980]","volume":"38","year":"2017","unstructured":"Baumgartner\n              H,\n            \n            \n              Falk\n              V,\n            \n            \n              Bax\n              JJ,\n            \n            \n              De Bonis\n              M,\n            \n            \n              Hamm\n              C,\n            \n            \n              Holm\n              PJ,\n            \n          \n          .\n\t\t\t\t\tESC\/EACTS guidelines for the management of valvular heart disease [published erratum appears in Eur Heart J 2018;39(21):1980].\n\t\t\t\t\tEur Heart J2017;38(36):2739\u201391."},{"issue":"1","key":"i1526-6702-49-1-e207435-b2","series-title":"Tex Heart Inst J","first-page":"29","article-title":"Transcatheter aortic valve replacement: comprehensive review and present status","volume":"44","year":"2017","unstructured":"Arora\n              S,\n            \n            \n              Misenheimer\n              JA,\n            \n            \n              Ramaraj\n              R.\n            \n          \n          Transcatheter aortic valve replacement: comprehensive review and present status.\n\t\t\t\t\tTex Heart Inst J2017;44(1):29\u201338."},{"issue":"1","key":"i1526-6702-49-1-e207435-b3","series-title":"Ann Cardiothorac Surg","first-page":"26","article-title":"Minimally invasive aortic valve surgery: state of the art and future directions","volume":"4","year":"2015","unstructured":"Glauber\n              M,\n            \n            \n              Ferrarini\n              M,\n            \n            \n              Miceli\n              A.\n            \n          \n          Minimally invasive aortic valve surgery: state of the art and future directions.\n\t\t\t\t\tAnn Cardiothorac Surg2015;4(1):26\u201332."},{"issue":"4","key":"i1526-6702-49-1-e207435-b4","series-title":"Interact Cardiovasc Thorac Surg","first-page":"624","article-title":"Minimal access versus conventional aortic valve replacement: a meta-analysis of propensity-matched studies","volume":"25","year":"2017","unstructured":"Shehada\n              SE,\n            \n            \n              Elhmidi\n              Y,\n            \n            \n              Mourad\n              F,\n            \n            \n              Wendt\n              D,\n            \n            \n              El Gabry\n              M,\n            \n            \n              Benedik\n              J,\n            \n          \n          .\n\t\t\t\t\tMinimal access versus conventional aortic valve replacement: a meta-analysis of propensity-matched studies.\n\t\t\t\t\tInteract Cardiovasc Thorac Surg2017;25(4):624\u201332."},{"issue":"4","key":"i1526-6702-49-1-e207435-b5","series-title":"Interact Cardiovasc Thorac Surg","first-page":"550","article-title":"Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease","volume":"12","year":"2011","unstructured":"Ozaki\n              S,\n            \n            \n              Kawase\n              I,\n            \n            \n              Yamashita\n              H,\n            \n            \n              Uchida\n              S,\n            \n            \n              Nozawa\n              Y,\n            \n            \n              Matsuyama\n              T,\n            \n          \n          .\n\t\t\t\t\tAortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease.\n\t\t\t\t\tInteract Cardiovasc Thorac Surg2011;12(4):550\u20133."},{"issue":"4","key":"i1526-6702-49-1-e207435-b6","series-title":"Eur J Cardiothorac Surg","first-page":"709","article-title":"Full sternotomy and minimal access approaches for surgical aortic valve replacement: a multicentre propensity-matched study","volume":"57","year":"2020","unstructured":"Paparella\n              D,\n            \n            \n              Malvindi\n              PG,\n            \n            \n              Santarpino\n              G,\n            \n            \n              Moscarelli\n              M,\n            \n            \n              Guida\n              P,\n            \n            \n              Fattouch\n              K,\n            \n          \n          .\n\t\t\t\t\tFull sternotomy and minimal access approaches for surgical aortic valve replacement: a multicentre propensity-matched study.\n\t\t\t\t\tEur J Cardiothorac Surg2020;57(4):709\u201316."},{"issue":"18","key":"i1526-6702-49-1-e207435-b7","series-title":"N Engl J Med","first-page":"1706","article-title":"Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","year":"2019","unstructured":"Popma\n              JJ,\n            \n            \n              Deeb\n              GM,\n            \n            \n              Yakubov\n              SJ,\n            \n            \n              Mumtaz\n              M,\n            \n            \n              Gada\n              H,\n            \n            \n              O'Hair\n              D,\n            \n          \n          .\n\t\t\t\t\tTranscatheter aortic-valve replacement with a self-expanding valve in low-risk patients.\n\t\t\t\t\tN Engl J Med2019;380(18):1706\u201315."},{"issue":"18","key":"i1526-6702-49-1-e207435-b8","series-title":"N Engl J Med","first-page":"1695","article-title":"Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","year":"2019","unstructured":"Mack\n              MJ,\n            \n            \n              Leon\n              MB,\n            \n            \n              Thourani\n              VH,\n            \n            \n              Makkar\n              R,\n            \n            \n              Kodali\n              SK,\n            \n            \n              Russo\n              M,\n            \n          \n          .\n\t\t\t\t\tTranscatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients.\n\t\t\t\t\tN Engl J Med2019;380(18):1695\u2013705."},{"issue":"2","key":"i1526-6702-49-1-e207435-b9","series-title":"Curr Opin Cardiol","first-page":"118","article-title":"Minimally invasive aortic valve replacement: how does this perform in high-risk patients?","volume":"26","year":"2011","unstructured":"Schmitto\n              J,\n            \n            \n              Mohr\n              FW,\n            \n            \n              Cohn\n              LH.\n            \n          \n          Minimally invasive aortic valve replacement: how does this perform in high-risk patients?\n          \n            Curr Opin Cardiol\n          \n          2011;26(2):118\u201322."},{"issue":"3","key":"i1526-6702-49-1-e207435-b10","series-title":"J Thorac Dis","first-page":"1588","article-title":"Right anterior mini-thoracotomy vs. conventional sternotomy for aortic valve replacement: a propensity-matched comparison","volume":"10","year":"2018","unstructured":"Del Giglio\n              M,\n            \n            \n              Mikus\n              E,\n            \n            \n              Nerla\n              R,\n            \n            \n              Micari\n              A,\n            \n            \n              Calvi\n              S,\n            \n            \n              Tripodi\n              A,\n            \n          \n          .\n\t\t\t\t\tRight anterior mini-thoracotomy vs. conventional sternotomy for aortic valve replacement: a propensity-matched comparison.\n\t\t\t\t\tJ Thorac Dis2018;10(3):1588\u201395."},{"issue":"4","key":"i1526-6702-49-1-e207435-b11","series-title":"Eur J Cardiothorac Surg","first-page":"793","article-title":"Minimally invasive aortic valve replacement with sutureless and rapid deployment valves: a report from an international registry (Sutureless and Rapid Deployment International Registry)","volume":"56","year":"2019","unstructured":"Berretta\n              P,\n            \n            \n              Andreas\n              M,\n            \n            \n              Carrel\n              TP,\n            \n            \n              Solinas\n              M,\n            \n            \n              Teoh\n              K,\n            \n            \n              Fischlein\n              T,\n            \n          \n          .\n\t\t\t\t\tMinimally invasive aortic valve replacement with sutureless and rapid deployment valves: a report from an international registry (Sutureless and Rapid Deployment International Registry).\n\t\t\t\t\tEur J Cardiothorac Surg2019;56(4):793\u20139."},{"issue":"2","key":"i1526-6702-49-1-e207435-b12","series-title":"Innovations (Phila)","first-page":"120","article-title":"Minimally invasive aortic valve replacement with sutureless valves: results from an international prospective registry","volume":"15","year":"2020","unstructured":"Glauber\n              M,\n            \n            \n              Di Bacco\n              L,\n            \n            \n              Cuenca\n              J,\n            \n            \n              Di Bartolomeo\n              R,\n            \n            \n              Baghai\n              M,\n            \n            \n              Zakova\n              D,\n            \n          \n          .\n\t\t\t\t\tMinimally invasive aortic valve replacement with sutureless valves: results from an international prospective registry.\n\t\t\t\t\tInnovations (Phila)2020;15(2):120\u201330."},{"issue":"6","key":"i1526-6702-49-1-e207435-b13","series-title":"J Card Surg","first-page":"435","article-title":"The role of ministernotomy in aortic valve surgery: a prospective randomized study","volume":"34","year":"2019","unstructured":"Vukovic\n              PM,\n            \n            \n              Milojevic\n              P,\n            \n            \n              Stojanovic\n              I,\n            \n            \n              Micovic\n              S,\n            \n            \n              Zivkovic\n              I,\n            \n            \n              Peric\n              M,\n            \n          \n          .\n\t\t\t\t\tThe role of ministernotomy in aortic valve surgery: a prospective randomized study.\n\t\t\t\t\tJ Card Surg2019;34(6):435\u20139."},{"issue":"6","key":"i1526-6702-49-1-e207435-b14","series-title":"J Thorac Cardiovasc Surg","first-page":"2379","article-title":"Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium","volume":"155","year":"2018","unstructured":"Ozaki\n              S,\n            \n            \n              Kawase\n              I,\n            \n            \n              Yamashita\n              H,\n            \n            \n              Uchida\n              S,\n            \n            \n              Takatoh\n              M,\n            \n            \n              Kiyohara\n              N.\n            \n          \n          Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium.\n\t\t\t\t\tJ Thorac Cardiovasc Surg2018;155(6):2379\u201387."}],"container-title":["Texas Heart Institute Journal"],"original-title":[],"link":[{"URL":"https:\/\/thij.kglmeridian.com\/view\/journals\/thij\/49\/1\/article-e207435.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/thij\/article-pdf\/doi\/10.14503\/THIJ-20-7435\/3008788\/i1526-6702-49-1-e207435.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thij.kglmeridian.com\/downloadpdf\/journals\/thij\/49\/1\/article-e207435.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thij.kglmeridian.com\/downloadpdf\/journals\/thij\/49\/1\/article-e207435.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T15:37:02Z","timestamp":1730993822000},"score":1,"resource":{"primary":{"URL":"https:\/\/thij.kglmeridian.com\/view\/journals\/thij\/49\/1\/article-e207435.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":14,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.14503\/thij-20-7435","relation":{},"ISSN":["1526-6702","0730-2347"],"issn-type":[{"value":"1526-6702","type":"electronic"},{"value":"0730-2347","type":"print"}],"subject":[],"published":{"date-parts":[[2022]]}}}