Partial versus Full Sternotomy for Aortic Valve Replacement

Abstract

Background: Minimal invasive approaches are used more frequently for aortic valve replacement (AVR). This study aimed to compare the outcomes of both minimally invasive upper mini-sternotomy and full sternotomy for AVR.
 Methods: 100 patients with isolated aortic valve disease were enrolled in this prospective observational study. We grouped the patients according to the technique, group A (n=40) underwent upper J-shaped mini-sternotomy, and group B (n=60) underwent full sternotomy. Study endpoints were operative times and pain score.
 Results: The mean age of the patients was 46.4±10.1 years. There was no difference in preoperative data between both groups. There was a significant difference in aortic cross-clamp time (87.2± 8.6 vs. 59.2± 6.6 min in group A and B, respectively, p= 0.001), and total bypass time (115.1± 9.2 vs. 75.3± 4.3 min in group A and B, respectively, p= 0.001) between both groups. The total operative time was 341±11.7 and 196.1±18.4 min in groups A and B, respectively (p= 0.001). The ICU stay was 29.4±8.2 hours in group A and 41.2±13.3 hours in group B (p= 0.001). Patients who had mini-sternotomy had lower pain (p= 0.001) and better patient satisfaction score (p< 0.001).
 Conclusion: J-shaped upper mini-sternotomy is a safe and effective strategy for aortic valve replacement. The procedure may be associated with decreased pain and comparable morbidity to the conventional approach.