First Multi-Center Data Corroborates Findings on Safety and Efficacy of Minimally Invasive Heart Surgery
Results Confirm NYU Medical Center Surgeons' Forecast for Increased Use in Bypass and Valve Surgery
NEW ORLEANS, LA - New data from the largest international multi-center trial to date support broader use of the port-access minimally invasive approach for both coronary bypass and mitral valve surgery, according to a paper presented today by surgeons from seven major medical centers at the annual meeting of the Society of Thoracic Surgeons. Data from more than 1,000 patients at 121 medical centers analyzed in this first report issued from the Port-Access International Registry (PAIR) show that minimally invasive cardiac surgery is safe, with a low incidence of complications that is equivalent to standard open-chest surgery.
"This report supports our earlier prediction that this would become the standard approach for virtually all valve surgery and 30 to 50 percent of bypass surgery done at centers around the world, and it has," said Stephen B. Colvin, M.D., chief of cardiothoracic surgery at New York University Medical Center and senior author of the PAIR study. "For the last two years it has been our preference for most patients because of its reproducible results and obvious benefits to the patient."
The results of the PAIR study suggest that patients undergoing coronary bypass or mitral valve surgery have fewer complications than do patients undergoing standard open-chest procedures.
The study compared morbidity and mortality data from 555 patients undergoing port-access minimally invasive coronary artery bypass grafting (CABG) surgery, 172 mitral valve replacements (MV rpl) and 127 mitral valve repairs (MV rpr) to cases reported from mid-1995 to mid-1996 in the Society of Thoracic Surgeons (STS) database. Patient data was collected for nine months beginning April 1, 1997 and analyzed for post-operative mortality and complications rates such as stroke, heart attack, abnormal heart rhythms, re-operation, renal and multi-organ failure.
"What is most exciting about this report is that the good results were consistent over a wide range of centers," said Aubrey C. Galloway, M.D., NYU Medical Center's director of surgical research and lead author of the PAIR study. "This further validates the results we've previously reported from NYU, which demonstrated that minimally invasive bypass and valve surgery is extremely safe and reproducible, results in less pain and allows patients to recover more quickly."
Of the various complications studied, the most significant differences were found in the rates of new onset post-operative arrhythmias, which occurred in 5 to 7 percent of the port-access minimally invasive group versus 17 to 24 percent in the STS group studied. Overall survival was 99 percent in the port-access coronary bypass group versus 97 percent of the STS standard open-chest group, who had more advanced coronary artery disease.
According to the authors, future research will focus on the measurement of long-term efficacy, quantifying recovery time and analyzing the impact of the port-access minimally invasive technique on patients' quality of life.
NYU Medical Center's Department of Cardiothoracic Surgery is internationally recognized for expertise in the early development and practice of minimally invasive surgical techniques in adults and children. NYU surgeons were instrumental in the clinical development of port-access technology.
Results Confirm NYU Medical Center Surgeons' Forecast for Increased Use in Bypass and Valve Surgery
NEW ORLEANS, LA - New data from the largest international multi-center trial to date support broader use of the port-access minimally invasive approach for both coronary bypass and mitral valve surgery, according to a paper presented today by surgeons from seven major medical centers at the annual meeting of the Society of Thoracic Surgeons. Data from more than 1,000 patients at 121 medical centers analyzed in this first report issued from the Port-Access International Registry (PAIR) show that minimally invasive cardiac surgery is safe, with a low incidence of complications that is equivalent to standard open-chest surgery.
"This report supports our earlier prediction that this would become the standard approach for virtually all valve surgery and 30 to 50 percent of bypass surgery done at centers around the world, and it has," said Stephen B. Colvin, M.D., chief of cardiothoracic surgery at New York University Medical Center and senior author of the PAIR study. "For the last two years it has been our preference for most patients because of its reproducible results and obvious benefits to the patient."
The results of the PAIR study suggest that patients undergoing coronary bypass or mitral valve surgery have fewer complications than do patients undergoing standard open-chest procedures.
The study compared morbidity and mortality data from 555 patients undergoing port-access minimally invasive coronary artery bypass grafting (CABG) surgery, 172 mitral valve replacements (MV rpl) and 127 mitral valve repairs (MV rpr) to cases reported from mid-1995 to mid-1996 in the Society of Thoracic Surgeons (STS) database. Patient data was collected for nine months beginning April 1, 1997 and analyzed for post-operative mortality and complications rates such as stroke, heart attack, abnormal heart rhythms, re-operation, renal and multi-organ failure.
"What is most exciting about this report is that the good results were consistent over a wide range of centers," said Aubrey C. Galloway, M.D., NYU Medical Center's director of surgical research and lead author of the PAIR study. "This further validates the results we've previously reported from NYU, which demonstrated that minimally invasive bypass and valve surgery is extremely safe and reproducible, results in less pain and allows patients to recover more quickly."
Of the various complications studied, the most significant differences were found in the rates of new onset post-operative arrhythmias, which occurred in 5 to 7 percent of the port-access minimally invasive group versus 17 to 24 percent in the STS group studied. Overall survival was 99 percent in the port-access coronary bypass group versus 97 percent of the STS standard open-chest group, who had more advanced coronary artery disease.
According to the authors, future research will focus on the measurement of long-term efficacy, quantifying recovery time and analyzing the impact of the port-access minimally invasive technique on patients' quality of life.
NYU Medical Center's Department of Cardiothoracic Surgery is internationally recognized for expertise in the early development and practice of minimally invasive surgical techniques in adults and children. NYU surgeons were instrumental in the clinical development of port-access technology.