Upper T mini-sternotomy for aortic valve operations.
OBJECTIVE
New minimally invasive approaches for cardiac surgical procedures are constantly being developed in the hope of decreasing patient morbidity and enhancing the postoperative recovery. This report reviews the use of an upper T mini-sternotomy approach to aortic valve surgery.


METHODS
Nine consecutive nonselected patients (5 men, 4 women, mean age, 66 years) underwent isolated aortic valve replacement with the use of this approach. Two patients had isolated aortic valve stenosis, three had isolated aortic valve incompetence, and four patients had mixed aortic valve disease.


RESULTS
In all cases, an excellent view of the aortic valve was obtained, aortic valve replacement with a bileaflet mechanical prostheses was performed, and no intraoperative difficulties were encountered. Mean aortic cross-clamp time was 83 min and mean cardiopulmonary bypass perfusion time was 97 min. All patients were extubated in the operating room at the end of the surgical procedure, and there were no postoperative complications. All patients were discharged home on postoperative day 3, and there were no late complications.


CONCLUSIONS
Through an upper T mini-sternotomy, aortic valve surgery can be performed in the conventional manner using standard surgical instruments with no alteration in cardiopulmonary bypass and myocardial protection routines. With this method, postoperative pain is reduced and patient recovery is expeditious.
Department of Surgery, Prince of Wales Hospital, Shatin, NT, Hong Kong. izzat@mailserv.cuhk.edu.hk
M B
MB
Izzat
A P
AP
Yim
M H
MH
El-Zufari
K S
KS
Khaw
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D002315:Cardiopulmonary Bypass; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007442:Intubation, Intratracheal; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010149:Postoperative Pain / Q000517:prevention & control; D010351:Patient Discharge; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*; D013997:Time Factors