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Mini-Sternotomy Versus Conventional Sternotomy In Aortic Valve Replacement Surgery; A Comparative Study.

Mohamed Khalid Bakr Ali1, Mohamed Moustafa Abdelaal1, Wael Mohamed Elfeky1

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Summary

Mini-sternotomy for aortic valve replacement (AVR) shows reduced postoperative bleeding and shorter hospital stays compared to conventional sternotomy. This less-invasive approach offers better outcomes for patients undergoing AVR.

Keywords:
Aortic valve, sternotomy, Blood Transfusion, Pain, Intensive Care Units.

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Cardiac Surgery

Background:

  • Conventional sternotomy for aortic valve replacement (AVR) is a well-established procedure.
  • Minimally invasive surgical techniques are increasingly explored to improve patient outcomes.

Purpose of the Study:

  • To compare the safety, efficacy, and efficiency of mini-sternotomy versus conventional sternotomy for AVR.
  • To evaluate short-term postoperative outcomes between the two surgical approaches.

Main Methods:

  • A comparative study involving 90 patients undergoing AVR (45 with full sternotomy, 45 with upper j-shaped mini-sternotomy).
  • Data collected from May 2019 to February 2022 at Kafrelsheikh University Hospital, Egypt.
  • Statistical analysis of collected data to assess outcomes.

Main Results:

  • No significant differences in cardiopulmonary bypass (CPB) or cross-clamp (CC) times between the approaches.
  • Mini-sternotomy group demonstrated significantly less postoperative bleeding (p<0.001) and lower blood transfusion rates (p<0.001).
  • Shorter intensive care unit (ICU) and total hospital stays were observed in the mini-sternotomy group (p=0.013 and p=0.022, respectively).

Conclusions:

  • Mini-sternotomy is a realistic and practical alternative for primary isolated AVR.
  • The less-invasive mini-sternotomy approach offers superior postoperative results compared to full sternotomy.