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Assessment Based on EuroSCORE of Ministernotomy for Aortic Valve Replacement

Cardiac Surgery Service, Erasme Hospital, University of Brussels, Brussels, Belgium

For reprint information contact: Jean-Marie De Smet, MD Tel: 32 2 555 3817 Fax: 32 2 555 6652 Email: jean-marie.de.smet{at}ulb.ac.be Cardiac Surgery Service, Hôpital Erasme, Route de Lennik 808, 1070 Brussels, Belgium.

To assess the advantages of a ministernotomy over a standard sternotomy for aortic valve replacement, 191 patients were classified as low-, medium-, and high-risk by EuroSCORE. A ministernotomy was carried out in 100 patients, and a standard sternotomy was used in 91. Among low-risk patients, those who had a ministernotomy showed a marginal increase in atrial fibrillation. Of the medium-risk patients, those who had a sternotomy had significantly more atrial fibrillation and slightly more general infections. In the high-risk subgroup, significantly more atrial fibrillation was observed in the sternotomy group, and more neurologic events were observed in the ministernotomy group; the difference became nonsignificant when only severe events were considered. There was a significant benefit in terms of rhythm disturbances in medium- and high-risk patients who underwent a ministernotomy compared to those who had a full sternotomy. Mortality, duration of intensive care, and hospital stay were not influenced by the operative method.

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