Comparison of limited and full sternotomy in aortic valve replacement.
OBJECTIVE
The practice of minimally invasive valve surgery remains controversial. The aim of this study was to evaluate the technical feasibility and postoperative course of aortic valve replacement through limited upper sternotomy compared to conventional full sternotomy.


METHODS
From May 1998 to August 2000, we performed 24 cases of isolated aortic valve replacements through the limited upper sternotomy approach (group M). During the same period, 18 patients received isolated aortic valve replacements through the conventional full sternotomy approach (group C). Operation duration, postoperative course and laboratory data were compared between the two groups.


RESULTS
All patients received a valve replacement with a prosthetic valve. There was no significant difference between the two groups in mean aortic cross-clamping time, mean cardiopulmonary bypass time or mean operation duration (skin to skin). No patient required blood transfusion. Patients in the group M were extubated earlier, with less postoperative blood loss and discharged earlier after the operation than those in group C. On the first postoperative day, the peak level of lactic acid dehydrogenease was significantly lower in the group M than those in group C.


CONCLUSIONS
Limited upper sternotomy for aortic valve replacement resulted in shorter operation duration and minimized operative risks for the patients. We believe this method brings not only cosmetic benefits but also improved postoperative course.
Suenaga
Etsuro
E
Department of Cardiovascular Surgery, Nagasaki Kouseikai Hospital, Nagasaki, Japan.
Suda
Hisao
H
Katayama
Yuji
Y
Sato
Manabu
M
Fujita
Hiroya
H
Yoshizumi
Ko
K
Itoh
Tsuyoshi
T
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome