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Lower hemisternotomy: infrequently used but versatile
Andreas Voetsch1, Andreas Winkler1, Philipp Krombholz-Reindl1
1Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University, Salzburg, Austria.
The Journal of Cardiovascular Surgery
|February 22, 2021
Summary
The lower hemisternotomy approach is a viable option for various cardiac surgeries, offering good clinical outcomes. This minimally invasive technique allows direct visualization of heart structures, making it a valuable alternative.
Area of Science:
- Cardiac Surgery
- Minimally Invasive Procedures
- Thoracic Surgery
Background:
- Lower hemisternotomy is an underutilized approach in cardiac surgery.
- This study evaluates the applicability and outcomes of cardiac procedures performed via lower hemisternotomy.
Purpose of the Study:
- To assess the clinical outcomes and applicability of the lower hemisternotomy approach.
- To determine the safety and efficacy of this minimally invasive cardiac surgery technique.
Main Methods:
- Retrospective review of 55 consecutive patients undergoing minimally invasive cardiac procedures via lower hemisternotomy from 2014-2019.
- Data collected included demographics, procedural details, and clinical outcomes with a median follow-up of 34 months.
Main Results:
- Procedures included mitral/tricuspid repairs, aortic valve replacement, and coronary artery bypass grafting.
- High repair rate (97.6%) for degenerative mitral insufficiency.
- Low reoperation rate (1.8%) for bleeding and acceptable 30-day mortality (3.6%).
Conclusions:
- Lower hemisternotomy is a suitable minimally invasive approach for selected cardiac procedures.
- Enables central aortic cannulation and direct visualization of intracardiac structures.
- Should be considered as an alternative minimally invasive surgical option.
