[Aortic valve replacement via J-shaped partial upper sternotomy: randomized trial, mid-term results].

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Conventional median sternotomy is the standard approach for aortic valve replacement.
• Minimally invasive techniques are increasingly explored to reduce surgical trauma and improve patient recovery.
• Evaluating novel sternotomy methods is crucial for advancing cardiac surgical practices.

Purpose of the Study:

• To compare the effectiveness and safety of upper partial J-shaped sternotomy versus conventional median sternotomy for aortic valve replacement.
• To assess key clinical outcomes, including mortality, complications, and long-term survival.
• To determine if the J-shaped sternotomy offers comparable results to the traditional approach.

Main Methods:

• A randomized controlled trial involving 112 patients undergoing isolated aortic valve replacement between 2012-2017.
• Patients were allocated to either median sternotomy (Group I) or upper partial J-shaped sternotomy (Group II).
• Data collected included demographics, preoperative valve gradients, operative times, in-hospital outcomes, and long-term follow-up.

Main Results:

• No significant difference in in-hospital mortality (1.8% vs. not specified, p=0.315) or postoperative complications between the two groups.
• Mean cross-clamp times were similar (65.5±12.5 min vs. 64.7±13.1 min, p=0.729).
• Kaplan-Meier survival rates (92.6% vs. 93.0%) and freedom from thromboembolic events (91.7% vs. 90%) were comparable at a mean follow-up of over 30 months.

Conclusions:

• Upper partial J-shaped sternotomy is a safe and effective surgical approach for aortic valve replacement.
• The outcomes of J-shaped sternotomy are similar to those of conventional median sternotomy.
• This technique represents a viable alternative for patients undergoing aortic valve surgery.