Comparing Mini-Sternotomy and Standard Sternotomy for Aortic Valve Replacement in Open Heart Surgeries

Osman, Dina Mohamed; Mansour, Muhammed Muhammed Ali; Mobasher, Magdy; Sobhy, Ehab; Tawfek, Amr El Sayed

doi:10.21608/zumj.2023.236426.2893

Comparing Mini-Sternotomy and Standard Sternotomy for Aortic Valve Replacement in Open Heart Surgeries

Document Type : Original Article

Authors

¹ cardiothoracic surgery zagazig university egypt

² Department of Cardiothoracic surgery, Faculty of Medicine, Zagazig University, Egypt

³ cardiothorathic surgery department, zagazig university

⁴ Cardiothoracic surgery department-Faculty of Medicine-Zagazig University

⁵ Department of Cardiothoracic Surgery,Zagazig Univeristy,Zagazig, Egypt

10.21608/zumj.2023.236426.2893

Abstract

Background: Aortic valve replacements (AVRs) are being carried out with minimal risk of complications. Reduced blood loss, shorter hospital stays, preservation of lung function, and lower incidence of atrial fibrillation are all benefits of less invasive techniques created for the benefit of patients. We aimed in this work to compare the outcome of patients undergoing aortic valve replacement in open heart surgeries via standard and mini sternotomy maneuvers (J-shaped).

Methods: We conducted a retrospective cohort study for twenty-four cases who had aortic valve disease that necessitates aortic valve surgery at the Cardiothoracic surgery department of Zagazig University Hospital. Twelve patients underwent aortic valve replacement by standard sternotomy and the other twelve patients by mini sternotomy (J shaped to the right third intercostal space).

Results: All of the total bypass, aortic cross-clamp times, as well as operative times, were significantly longer in the mini-sternotomy group (P< 0.001). Mechanical ventilation (MV) duration as well as hospital stay were significantly shorter in the mini (p values=0.04 and 0.001 respectively) while total drain was significantly higher in the standard group (p=0.001). Post-operative pain score and pethidine dose were significantly higher in the standard sternotomy group. Incidence of infection as well as blood transfusion were significantly higher among the standard group (p=0.02 and 0.007 respectively).

Conclusion: Mini sternotomy appears advantageous due to shorter mechanical ventilation times, potentially facilitating quicker postoperative recovery. It may also offer improved postoperative pain control. The patient's preferences, risk considerations, and intended outcomes should all be considered in making the decision

Keywords

Main Subjects