Minimal vs median sternotomy for aortic valve replacement.
The aim of this study was to compare postoperative outcomes in patients undergoing aortic valve replacement through a ministernotomy or conventional sternotomy. Sixty patients were randomized into 2 groups of 30 each: group 1 had a full sternotomy and group 2 had a ministernotomy. Pain was evaluated on a daily basis, pulmonary function tests were performed perioperatively. The skin incision was shorter in group 2 (7.17 vs 24.50 cm in group 1). There was significantly less mediastinal drainage in group 2 (233 vs 590 mL in 24 hours in group 1). Group 1 patients had more blood transfusions and longer ventilation time. In group 1, 96.7% experienced severe pain, whereas 93.3% in group 2 reported minimal pain. Hospital stay was 17.7 days in group 1 and 8.0 days in group 2. The ministernotomy had a cosmetic advantage, less blood loss and transfusion requirement, greater sternal stability, better respiratory function, and earlier extubation and hospital discharge.
Department of Cardiothoracic Surgery, Mansoura University, Mansoura, Egypt. elbalam2006@yahoo.com
Moustafa A
MA
Moustafa
Ayman A
AA
Abdelsamad
Gamal
G
Zakaria
Magdy M
MM
Omarah
D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001803:Blood Transfusion; D002921:Cicatrix / Q000209:etiology; D004322:Drainage; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011474:Prosthesis Design; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D013249:Sternum / Q000601:surgery*; D016896:Treatment Outcome