TY - JOUR
T1 - The Effect of Minimally Invasive Surgery and Sternotomy on Physical Activity and Quality of Life
AU - Moscarelli, Marco
AU - Lorusso, Roberto
AU - Abdullahi, Yusuf
AU - Varone, Egidio
AU - Marotta, Marco
AU - Solinas, Marco
AU - Casula, Roberto
AU - Parlanti, Alessandra
AU - Speziale, Giuseppe
AU - Fattouch, Khalil
AU - Athanasiou, Thanos
N1 - Funding Information:
This study was sponsored by Imperial College London . The study coordination centre was Hammersmith Hospital. The collaborating centre was Fondazione Toscana Gabriele Monasterio, Ospedale del Cuore Pasquinucci, Massa. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health and Social Care. The authors would like to thank Dr Ashley Symons ( symonsediting@gmail.com ) for the professional scientific editing of this article.
Funding Information:
This study was sponsored by Imperial College London. The study coordination centre was Hammersmith Hospital. The collaborating centre was Fondazione Toscana Gabriele Monasterio, Ospedale del Cuore Pasquinucci, Massa. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health and Social Care. The authors would like to thank Dr Ashley Symons for the professional scientific editing of this article.
Publisher Copyright:
© 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)
PY - 2021/6
Y1 - 2021/6
N2 - Aim: The aim of this study was to compare minimally invasive surgery (MI) and median sternotomy (MS) in terms of post-procedure health-related quality of life (HRQoL) and functional outcome. Method: We conducted a multicentre prospective cohort study that enrolled patients from January 2015 until February 2017. Combined cardiac procedures were performed with MS and isolated valve procedures with either MS or MI, depending on patient preference and surgeon experience. HRQoL was measured using the five-level version of the EQ-5D (EQ-5D-5L) and physical activity before and after surgery was evaluated using a wearable accelerometer. Activity patterns and intensity recorded by the accelerometer in each period were classified as “sedentary”, “light physical activity”, “moderate physical activity”, and “vigorous physical activity” for each patient. We also conducted a sub-analysis of frail patients in each group, as identified by the Reported Edmonton Frail Scale (>10 points). Patients were followed for 1 year. Results: The study included 100 consecutive patients who underwent MI (n=50) or MS (n=50) during the study period. Patients in the MI group showed a faster recovery of physical activity in the immediate postoperative period and superior HRQoL in the first 3 months (both p<0.001) versus the MS group. Differences between the MI and MS group were indistinguishable over a longer follow-up. A similar correlation was observed in the frailty subanalysis. Overall, the MS group had a higher cumulative incidence of events than the MI group (p<0.001). Conclusions: Compared to conventional MS, MI was associated with better HRQoL and early functional outcome, even in frail patients.
AB - Aim: The aim of this study was to compare minimally invasive surgery (MI) and median sternotomy (MS) in terms of post-procedure health-related quality of life (HRQoL) and functional outcome. Method: We conducted a multicentre prospective cohort study that enrolled patients from January 2015 until February 2017. Combined cardiac procedures were performed with MS and isolated valve procedures with either MS or MI, depending on patient preference and surgeon experience. HRQoL was measured using the five-level version of the EQ-5D (EQ-5D-5L) and physical activity before and after surgery was evaluated using a wearable accelerometer. Activity patterns and intensity recorded by the accelerometer in each period were classified as “sedentary”, “light physical activity”, “moderate physical activity”, and “vigorous physical activity” for each patient. We also conducted a sub-analysis of frail patients in each group, as identified by the Reported Edmonton Frail Scale (>10 points). Patients were followed for 1 year. Results: The study included 100 consecutive patients who underwent MI (n=50) or MS (n=50) during the study period. Patients in the MI group showed a faster recovery of physical activity in the immediate postoperative period and superior HRQoL in the first 3 months (both p<0.001) versus the MS group. Differences between the MI and MS group were indistinguishable over a longer follow-up. A similar correlation was observed in the frailty subanalysis. Overall, the MS group had a higher cumulative incidence of events than the MI group (p<0.001). Conclusions: Compared to conventional MS, MI was associated with better HRQoL and early functional outcome, even in frail patients.
KW - Conventional sternotomy
KW - Functional outcome
KW - Health-related quality of life
KW - Minimally invasive valve surgery
KW - MITRAL-VALVE SURGERY
KW - HIGH-RISK PATIENTS
KW - METAANALYSIS
U2 - 10.1016/j.hlc.2020.09.936
DO - 10.1016/j.hlc.2020.09.936
M3 - Article
C2 - 33191139
SN - 1443-9506
VL - 30
SP - 882
EP - 887
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 6
ER -