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Updated: Feb 12, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Outcomes of aortic valve replacement via partial upper sternotomy versus conventional aortic valve replacement in
Henryk A Welp1, Isabell Herlemann1, Sven Martens1
1Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University Hospital Münster, Münster, Germany.
Objectives:
Excellent outcomes after minimally invasive aortic valve replacement (mini-AVR) have been reported. Therefore, mini-AVR has become a popular treatment option in many cardiac surgery centres. However, whether obese patients particularly benefit from mini-AVR remains unclear. The aim of the present study was to evaluate outcomes of AVR performed through partial upper sternotomy compared to AVR through a full sternotomy (full-AVR) in obese patients.
Methods:
We retrospectively reviewed the medical records of all patients who underwent isolated AVR at our institution, and 217 consecutive obese [body mass index (BMI) >30 kg/m2] patients were identified. Outcomes of the mini-AVR group were compared with the full-AVR group.
Results:
One hundred and twenty-six patients underwent mini-AVR and 91 patients had full-AVR. The mean age and BMI were 69.8 ± 10.4 years and 32.6 ± 3.1 kg/m2 in the mini-AVR group compared to 70.0 ± 10.5 years and 33.1 ± 3.0 kg/m2 in the full-AVR group. Mortality, myocardial infarction, stroke, renal failure and surgical site infections were equivalent. Mini-AVR was associated with decreased ventilation time [6 h (minimum, min 3 h; maximum, max 76 h) vs 8 h (min 3 h; max 340 h); P = 0.004], shorter intensive care unit (ICU) stay [2 days (min 1 day; max 25 days) vs 4 days (min 1 day; max 35 days); P = 0.031] and reduced transfusion requirements (26.5% vs 56.0%; P = 0.004). Total duration of hospital stay as well as postoperative pain levels were comparable.
Conclusions:
Patient safety was not affected by mini-AVR. Significant benefits in terms of decreased transfusion requirements, ventilator times and ICU times were found in the mini-AVR group. Consequently, mini-AVR, performed through partial upper sternotomy, should also be routinely offered to obese patients.
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