title: Aortic Valve Replacement: Treatment by Sternotomy versus Minimally Invasive Approach.
abstract: To compare the results of aortic valve replacement with access by sternotomy or minimally invasive approach.
  
  
  
  Retrospective analysis of medical records of 37 patients undergoing aortic valve replacement by sternotomy or minimally invasive approach, with emphasis on the comparison of time of cardiopulmonary bypass and aortic clamping, volume of surgical bleeding, time of mechanical ventilation, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit, time of hospital discharge, short-term mortality and presence of surgical wound infection.
  
  
  
  Sternotomy was used in 22 patients and minimally invasive surgery in 15 patients. The minimally invasive approach had significantly higher time values of cardiopulmonary bypass (114.3±23.9 versus 86.7±19.8min.; P=0.003), aortic clamping (87.4±19.2 versus 61.4±12.9 min.; P<0.001) and mechanical ventilation (287.3±138.9 versus 153.9±118.6 min.; P=0.003). No difference was found in outcomes surgical bleeding volume, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit and time of hospital discharge. No cases of short-term mortality or surgical wound infection were documented.
  
  
  
  The less invasive approach presented with longer times of cardiopulmonary bypass, aortic clamping and mechanical ventilation than sternotomy, however without prejudice to the length of stay in intensive care unit, time of hospital discharge and morbidity.
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brazil and Pitangueiras Hospital, Jundiaí, SP, Brazil.
authors.forename: Renata Tosoni Rodrigues
authors.initials: RT
authors.lastname: Ferreira
authors.affiliation: Pitangueiras Hospital, Jundiaí, SP, Brazil; Hospital Paulo Sacramento, Jundiaí, SP, Brazil and Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rocha e Silva
authors.affiliation: Faculdade de Medicina de Jundiaí (FMJ), Jundiaí, SP, Brazil.
authors.forename: Evaldo
authors.initials: E
authors.lastname: Marchi
mesh_terms: D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D056346:Sternotomy; D016896:Treatment Outcome