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Minimal vs Median Sternotomy for Aortic Valve Replacement

Departments of Cardiothoracic Surgery
¹ Department of Cardiology
² Department of Anesthesia
³ Department of Chest Medicine Mansoura University Mansoura, Egypt

For reprint information contact: Moustafa A Moustafa, MD, Tel: 965 482 4821, Fax: 965 778 5297, Email: elbalam2006{at}yahoo.com, Cardiac Surgery Department, Chest Diseases Hospital, Kuwait.

The aim of this study was to compare postoperative outcomes in patients undergoing aortic valve replacement through a ministernotomy or conventional sternotomy. Sixty patients were randomized into 2 groups of 30 each: group 1 had a full sternotomy and group 2 had a ministernotomy. Pain was evaluated on a daily basis, pulmonary function tests were performed perioperatively. The skin incision was shorter in group 2 (7.17 vs 24.50 cm in group 1). There was significantly less mediastinal drainage in group 2 (233 vs 590 mL in 24 hours in group 1). Group 1 patients had more blood transfusions and longer ventilation time. In group 1, 96.7% experienced severe pain, whereas 93.3% in group 2 reported minimal pain. Hospital stay was 17.7 days in group 1 and 8.0 days in group 2. The ministernotomy had a cosmetic advantage, less blood loss and transfusion requirement, greater sternal stability, better respiratory function, and earlier extubation and hospital discharge.