Mini-sternotomy aortic valve replacement: is it safe and effective? Comparison with standard techniques

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Mini-sternotomy aortic valve replacement (MSAVR) adoption has increased since 2003.
• Conventional sternotomy aortic valve replacement (SAVR) is the traditional approach.

Purpose of the Study:

• To compare the clinical outcomes of MSAVR versus SAVR.
• To evaluate the safety and efficacy of MSAVR.

Main Methods:

• A retrospective analysis of 143 patients undergoing aortic valve replacement (AVR) between 1998 and 2008.
• Comparison of 61 MSAVR patients with 82 SAVR patients.
• Utilized reversed-L-shaped median sternotomy for MSAVR with standard cardiopulmonary bypass (CPB) techniques.

Main Results:

• MSAVR patients were younger with higher ejection fraction and lower diabetes incidence.
• MSAVR had longer aortic cross-clamp (49 vs. 44.5 min) and CPB times (77 vs. 60 min).
• Postoperative recovery, hospital stay, 30-day mortality, and 5-year cardiac-related death rates were similar between groups.

Conclusions:

• MSAVR is technically demanding, requiring longer CPB and cross-clamp times.
• With experience, MSAVR yields results comparable to SAVR.
• MSAVR offers acceptable cosmetic results alongside comparable clinical outcomes.