DEPT. OF CARDIOTHORACIC SURGERY, MADANI HEART HOSPITAL, TABRIZ, IRAN
Background: Mini sternotomy approach for aortic valve surgery is an alternative to median sternotomy to minimize surgical trauma. In this study, we report our experience with mini sternotomy and compare it with full sternotomy in patients undergoing aortic valve operations.
Methods: From March 2002 to December 2003, 20 aortic and subaortic operations were performed by one group of surgeons through partial upper sternotomy approach. Fifteen patients had primary isolated aortic valve replacement, two patients had aortic valve commissurotomy and three patients had sub aortic membrane resection. A comparison group included twenty matched patients operated on through a full median sternotomy from 2001.
Results: There were 16 male and 4 female patients with a mean age of 37±19 years in each group.
There was no difference in the patients' demographics between both groups. Mean cardiopulmonary bypass (CPB) and aortic cross-clamp times were significantly longer in the mini sternotomy group (0.01). Minor complications were comparable, and hospital stay was longer in the full sternotomy group (0.03). Right internal mammary artery damage occurred in two cases in the mini sternotomy group.
Conclusion: Despite longer CPB and aortic cross - clamp times in our initial experience, mini sternotomy for aortic valve surgery are a safe and effective approach with some technical difficulties.