The evidence was of very low to moderate certainty. Sample sizes were small and underpowered to demonstrate differences in some outcomes. Clinical heterogeneity was also noted. Considering these limitations, there may be little to no effect on mortality. Differences in extracorporeal support times are uncertain, comparing upper hemi-sternotomy to full sternotomy for aortic valve replacement. Before widespread adoption of the minimally invasive approach can be recommended, there is a need for a well-designed and adequately powered prospective randomised controlled trial. Such a study would benefit from also performing a robust cost analysis. Growing patient preference for minimally invasive techniques merits thorough quality of life analyses to be included as end points, as well as quantitative measures of physiological reserve.
Keyphrases
- aortic valve replacement
- minimally invasive
- transcatheter aortic valve implantation
- aortic valve
- aortic stenosis
- transcatheter aortic valve replacement
- robot assisted
- ejection fraction
- case report
- risk factors
- cardiovascular events
- high resolution
- high intensity
- single cell
- left ventricular
- type diabetes
- clinical trial
- atrial fibrillation
- heart failure
- adipose tissue
- skeletal muscle
- glycemic control