title: Right minithoracotomy versus full sternotomy for the aortic valve replacement: preliminary results.
abstract: BACKGROUND
  Minimally invasive surgery (MIS) for aortic valve replacement (AVR) is going to increase with different techniques described so far. We hereby report the results of AVR through a right minithoracotomy (RM) compared to a median sternotomy (MS).
  
  
  METHODS
  One hundred patients operated for isolated AVR by the same surgeon (chief of the department) were enrolled and allocated to: MS (group A, 50 patients, 26 females, mean age 69.9 ± 12.4 years). RM (group B, 50 patients, 27 females, mean age 71.6 ± 11.2 years). Mean logistic Euroscores were, respectively, 6.5 ± 4.0 and 8.0 ± 5.9 (p=ns).
  
  
  RESULTS
  Mean duration of cardiopulmonary by-pass (CPB) was 62.8 ± 18.3 min in group A and 101.4 ± 35.2 min in group B (p<0.05); cross-clamp was 44.8 ± 13.4 min in group A and 74.6 ± 26.7 min in group B (p<0.05). Thirty-day mortality was 2 (4%) in group A and 0 in group B (p=ns). ICU stay and hospital stay did not significantly differ amongst two groups. The incidence of bleeding was lower in group B, showing a slight reduction of blood transfusions and re-explorations (p=ns).
  
  
  CONCLUSIONS
  Our experience shows that RM offers a good 30-day survival and a lower incidence of mediastinitis or osteomyelitis. The risk of insufficient vision or sudden complications is safely managed by enlarging the surgical incision through a transverse sternotomy.
authors.affiliation: Division of Cardiac Surgery, Mauriziano Umberto I Hospital, L.go Turati 62, 10135 Turin, Italy. fabrisans@katamail.com
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sansone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Punta
authors.forename: Francesco
authors.initials: F
authors.lastname: Parisi
authors.forename: Guglielmo Mario Actis
authors.initials: GM
authors.lastname: Dato
authors.forename: Edoardo
authors.initials: E
authors.lastname: Zingarelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Flocco
authors.forename: Pier Giuseppe
authors.initials: PG
authors.lastname: Forsennati
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Bardi
authors.forename: Stefano
authors.initials: S
authors.lastname: del Ponte
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casabona
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D016009:Chi-Square Distribution; D005260:Female; D006305:Health Status Indicators; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D056346:Sternotomy / Q000295:instrumentation / Q000379:methods*; D013908:Thoracotomy / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors