Application of inverted J-shaped partial sternotomy in intracardiac operations.
OBJECTIVE
To report our experience of intracardiac surgery with an inverted J-shaped partial sternotomy (IJPS) and describe the technical details of this approach.


METHODS
From January to December 2002, 31 patients underwent intracardiac operations using the IJPS instead of a standard conventional full-length median sternotomy (FLMS). Twenty-one patients had mitral valve replacements (MVR), with combined tricuspid valvuloplasty in three, six had closure of secundum atrial septal defects, three had closure of ventricular septal defects and one had repair of cor triatriatum. Data from 26 randomly selected patients who had undergone MVR through a conventional FLMS were included for comparison.


RESULTS
There were no perioperative or in-hospital deaths in either group. There was a significant difference between the two MVR groups in incision length, mediastinal drainage and blood transfusion volume, but not in cardiopulmonary bypass time, aortic cross-clamp time, duration of operation and duration of ventilatory support. There were no conversions from IJPS to FLMS, indicating that access was satisfactory for all the procedures. All patients were discharged without any significant postoperative complications.


CONCLUSIONS
The IJPS is aesthetically pleasing with regard to cosmesis and does not affect safety and exposure. Furthermore, the smaller incision resulted in a significant reduction in blood loss and blood requirements.
Li
Wei
W
Department of Cardiovascular Surgery, Shanghai Chest Hospital, China. schliweimd@hotmail.com
Li
Yingze
Y
Chong
William Chee Fui
WC
Sim
Eugene Kwang Wei
EK
D006348:Cardiac Surgical Procedures / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010149:Postoperative Pain; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D013249:Sternum / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology