A comparative study between mini versus full sternotomy aortic valve replacement

Abstract

Background Aortic valve replacement for treatment of aortic valve diseases is quite common. Minimally invasive procedures have gained a lot of popularity in recent years with the claimed better early postoperative outcomes in comparison with conventional techniques. Objective The aim was to compare early postoperative outcomes after ministernotomy versus conventional median sternotomy aortic valve replacement. Patients and methods The authors prospectively studied 60 patients who underwent aortic valve replacement surgery at the National Heart Institute between the period of May 2020 and July 2021. A total of 30 patients had aortic valve replacement via upper ministernotomy approach, whereas the other 30 patients had aortic valve replacement using conventional median sternotomy. Early postoperative results were compared with each other. Results There was no morality throughout the study. The mean age was 45.8 ± 15.13 years in the conventional group and 51.13 ± 17.8 in the ministernotomy group. Perioperative data showed no significant difference between the two groups, except for aortic orifice (root) diameter, which was wider in the ministernotomy group. The cross-clamp time was 60.33 ± 8.27 in the conventional group and 70.66 ± 6.91 in the ministernotomy group, and the total bypass time was 77.0 ± 8.46 and 88.1 ± 9.55, respectively, with significant difference between the two groups. Postoperative pain levels showed a statistically significant difference and were less severe in the ministernotomy group, and the total hospital stay was shorter in the ministernotomy group, with significant difference between the two groups. Conclusion The use of upper ministernotomy approach to replace a diseased aortic valve is safe and can be compared with the conventional median sternotomy approach.

Keywords

• aortic valve replacement
• conventional median sternotomy
• ministernotomy