{
  "abstract": "Background/Objectives: Stroke is a devastating complication after aortic valve replacement (AVR). Whether minimally invasive AVR (miniAVR) reduces perioperative stroke risk versus conventional sternotomy remains uncertain. Methods: This single-center retrospective cohort study used propensity score matching (PSM) in 1741 consecutive patients undergoing isolated AVR (2014–2025). After exclusions, 1:1 PSM using 10 covariates created 155 matched pairs with excellent balance (all standardized mean differences < 0.20). The primary endpoint was in-hospital stroke or transient ischemic attack (TIA); secondary endpoints were 30-day and 5-year mortality and major complications. Firth penalized logistic regression identified independent predictors of stroke/TIA. Results: Stroke/TIA occurred in 0/155 (0.0%) miniAVR versus 7/155 (4.5%) conventional patients (p = 0.015); the rule-of-three upper 95% limit for miniAVR was ~1.9%. Thirty-day mortality was similar (0.6% vs. 2.6%; p = 0.371). Five-year survival favored miniAVR (94.6% vs. 87.2%; log-rank p = 0.047). miniAVR was independently associated with lower stroke/TIA odds (odds ratio [OR] 0.052; 95% confidence interval [CI] 0.003–0.832; p = 0.037); longer cardiopulmonary bypass time was associated with higher odds (OR 1.014/minute; 95% CI 1.001–1.028; p = 0.032). Conclusions: miniAVR was associated with zero observed perioperative strokes and higher 5-year survival; however, this survival comparison is limited by short median follow-up in the miniAVR group (1.9 years). Given the small number of events and the single-center design, these findings should not be interpreted as proof of a causal neuroprotective effect. Multicenter validation with longer, balanced follow-up is required.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiac Surgery, Upper-Silesian Heart Center, 40-635 Katowice, Poland",
    "Department of Cardiac Surgery, Medical University of Silesia, 40-055 Katowice, Poland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Adam Ryszard Kowalówka",
      "orcid": "0000-0002-8239-9099"
    },
    {
      "affs": [
        1
      ],
      "name": "Julia Wojtczak"
    },
    {
      "affs": [
        1
      ],
      "name": "Maria Zwinczak"
    },
    {
      "affs": [
        1
      ],
      "name": "Barbara Wawrzyńczak"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Mikołaj Jodłowski",
      "orcid": "0009-0001-3523-7396"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Radosław Gocoł"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cphc8hz7w6ekm.bib",
  "cited_by": 1,
  "doi": "10.3390/jcm15207803",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705071/?tool=EBI",
  "id": "cphc8hz7w6ekm",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7803",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7221353707",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705071/pdf/?tool=EBI",
  "pmcid": "PMC13705071",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/cphc8hz7w6ekm.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207803",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7803"
    },
    {
      "first_seen": "2026-10-30T12:21:40Z",
      "native_id": "PMC:PMC13705071",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705071"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Minimally Invasive Aortic Valve Replacement and Perioperative Stroke Risk: A Propensity-Matched Analysis",
  "title_text": "Minimally Invasive Aortic Valve Replacement and Perioperative Stroke Risk: A Propensity-Matched Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:40Z",
  "url": "https://research.draconitic.com/paper/cphc8hz7w6ekm",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}