[Ministernotomy for aortic valve surgery: report of 20 patients]

Aortic valve surgery can be performed through a reduced mid sternotomy with excellent long term results.

To report the initial results obtained with this technique.

Descriptive study of 20 patients aged 48+/-11 years, subjected to valve replacement surgery for aortic valve disease between 2004 and 2007. Arterial and venous cannulation were performed with the usual method and extracorporeal circulation was performed with a mean perfusion of 4.5 L/min. Hypothermia and cardioplegia were performed infusing the hematic cardioplegic solution at 4 degrees C in the aortic root or coronary ostia.

Sixteen patients were in functional class (FC) III. Fourteen patients had aortic insufficiency and six had predominant stenosis. There was no operative mortality One patient had a left hemothorax and was reoperated. All patients were discharged between 4 and 6 days after surgery. Mean follow-up was 21 +/- 4 months. All patients are in FC I and free from cardiac events. Echocardiographic assessment was done in 16 patients, showing a good motility of valve disks. Actuarial survival probability was 100% and probability of freedom from cardiac events was 100% at 42 months of follow-up.

Ministernotomy is an excellent approach for aortic valve surgery providing good visualization of the ascending aorta, simplifying the surgical technique.