title: Partial median "I" sternotomy: minimally invasive alternate approach for aortic valve replacement.
abstract: Minimally invasive aortic valve replacement using the inversed L-like partial upper sternotomy has evolved during the last 10 years. It is performed with excellent results with regard to sternal stability and cosmesis. However, the lateral incision may result in sternal overriding, instability, or fracture. We present an alternate minimally invasive approach to aortic valve replacement. We performed a partial median "I" sternotomy in 30 consecutive patients: After a 6- to 8-cm skin incision, the sternum was incised from the jugulum downward to the corpus, ending at the level of the fourth or fifth intercostal space. No lateral incision of the sternum was performed. The access to the heart and aorta was excellent. During the postoperative course and during follow-up, clinical examination revealed sternal stability and normal wound healing in all patients. These results show that the partial median I sternotomy can be performed safely and provides excellent clinical and cosmetic results.
authors.affiliation: Department of Cardiothoracic Surgery, German Heart Center Munich, Technical University of Munich, Munich, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Boehm
authors.forename: Paul
authors.initials: P
authors.lastname: Libera
authors.forename: Albrecht
authors.initials: A
authors.lastname: Will
authors.forename: Stefan
authors.initials: S
authors.lastname: Martinoff
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Wildhirt
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013249:Sternum / Q000601:surgery*