Comparison Between Mini-Sternotomy and Full Sternotomy for Aortic Valve Replacement: A 10-Year Retrospective Study

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Minimally Invasive Surgery

Background:

• Aortic valve replacement (AVR) is a critical intervention for moderate to severe aortic valve stenosis.
• Conventional sternotomy is the standard surgical approach, but minimally invasive techniques are evolving.

Purpose of the Study:

• To compare the clinical outcomes of minimally invasive mini-sternotomy versus conventional full sternotomy for AVR.
• To evaluate patient-related and intraoperative parameters between the two surgical approaches.

Main Methods:

• A 10-year retrospective study involving 371 patients undergoing AVR.
• Comparison of outcomes including operative time, bleeding, cardiopulmonary bypass time, aortic cross-clamp time, hospital stay, ICU stay, and complication rates (sternal wound dehiscence, atrial fibrillation, stroke, perioperative myocardial infarction).

Main Results:

• Full sternotomy was associated with significantly lower bleeding (p=0.002).
• Operative time was significantly higher in the mini-sternotomy group.
• Hospital stay, ICU stay, and deep sternal wound dehiscence were statistically insignificant between groups.
• Rates of atrial fibrillation, sternal wound dehiscence, stroke, and perioperative myocardial infarction were similar.

Conclusions:

• Mini-sternotomy is a safe and viable alternative for AVR.
• While complication rates are comparable, mini-sternotomy may offer reduced hospital and ICU lengths of stay.