title: Treatment of ascending aorta disease with Bentall-De Bono operation using a mini-invasive approach.
abstract: BACKGROUND
  Use of minimally invasive approaches in cardiac surgery is increasing, obtaining a wide consensus and representing a challenging alternative technique for many surgeons. We report our experience of the treatment of ascending aorta disease using the Bentall-De Bono procedure through a minimally invasive approach.
  
  
  METHODS
  Between September 1997 and June 2005 at 'Policlinico San Matteo', Pavia, we treated 40 patients affected by ascending aorta disease and aortic valve regurgitation using a Bentall-De Bono procedure through a minimally invasive approach, by means of a reversed T or J ministernotomy. Data were analyzed retrospectively. Thirty patients were men. Short-term and mid-term mortality and peroperative complications were analyzed.
  
  
  RESULTS
  None of the patients died during the 30-day postoperative period. The mean ICU and length of stay times were 3.3 +/- 8.2 and 9.3 +/- 7.2 days, respectively. Six patients (15%) had one or more postoperative complications. One patient (2.5%) underwent early reoperation for bleeding. None underwent a procedure-related reoperation. Mechanical ventilation was longer than 48 h in five patients (12.5%). The mean follow-up was 38.4 +/- 31 months. Survival at 1, 3 and 5 years was, respectively, 94.1, 90.6 and 90.6%. At the end of the follow-up, there were 37 survivors. Twenty-seven (73%) patients were in New York Heart Association I, six (16%) were in New York Heart Association II and four (11%) were in New York Heart Association III.
  
  
  CONCLUSIONS
  Reversed T or J ministernotomy is a feasible and secure alternative to complete sternotomy. The short incision may enhance the outcome and does not affect the survival, offering proper access to the anatomic structures.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital 'G. Martino', Messina, Italy. perrottasossio@yahoo.com
authors.forename: Sossio
authors.initials: S
authors.lastname: Perrotta
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lentini
authors.forename: Mauro
authors.initials: M
authors.lastname: Rinaldi
authors.forename: Andrea M
authors.initials: AM
authors.lastname: D'armini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tancredi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Raffa
authors.forename: Roberto
authors.initials: R
authors.lastname: Gaeta
authors.forename: Mario
authors.initials: M
authors.lastname: Viganó
mesh_terms: D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects