title: Comparison of limited and full sternotomy in aortic valve replacement.
abstract: 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.
authors.affiliation: Department of Cardiovascular Surgery, Nagasaki Kouseikai Hospital, Nagasaki, Japan.
authors.forename: Etsuro
authors.initials: E
authors.lastname: Suenaga
authors.forename: Hisao
authors.initials: H
authors.lastname: Suda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Katayama
authors.forename: Manabu
authors.initials: M
authors.lastname: Sato
authors.forename: Hiroya
authors.initials: H
authors.lastname: Fujita
authors.forename: Ko
authors.initials: K
authors.lastname: Yoshizumi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Itoh
mesh_terms: 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