Related Experiment Video
Updated: May 6, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
11.3K
Partial versus Complete Sternotomy for Aortic Valve Replacement-Multicenter Study.
Nora Goebel1, Tomasz Stankowski2, Francesco Pollari3
1Robert-Bosch-Krankenhaus GmbH, Stuttgart, Baden-Wuerttemberg, Germany.
The Thoracic and Cardiovascular Surgeon
|April 16, 2024
Summary
Partial upper sternotomy for aortic valve replacement shows comparable major adverse events to complete sternotomy. However, minimally invasive approaches offer shorter ICU stays and reduced rehospitalization rates.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Aortic Valve Replacement
Background:
- The comparative benefits of minimally invasive cardiac surgery are not well-established.
- Surgical aortic valve replacement (SAVR) outcomes via partial upper sternotomy (PUS) versus complete median sternotomy (MS) require evaluation.
Purpose of the Study:
- To compare short- and mid-term outcomes of SAVR using PUS versus MS.
- To assess the safety and efficacy of minimally invasive SAVR.
Main Methods:
- A large, German multicenter cohort study included 2,929 patients undergoing isolated SAVR between 2016-2020.
- Propensity-score matching created a cohort of 1,990 patients for analysis.
- Primary endpoint: major adverse cardiac and cerebrovascular events (MACCE) at 30 days and 5-year follow-up.
Main Results:
- Unadjusted MACCE rates were lower with PUS, but not statistically significant after propensity-score matching (30-day: 3.9% PUS vs. 5.4% MS; 5-year: 9.9% PUS vs. 11.3% MS).
- The PUS group demonstrated significantly shorter intensive care unit (ICU) stays, fewer cases of Dressler's syndrome, and reduced rehospitalization rates.
- Conversion to full sternotomy occurred in 3.8% of PUS cases.
Conclusions:
- Surgical aortic valve replacement via partial upper sternotomy and complete median sternotomy yield comparable MACCE rates.
- Partial upper sternotomy is associated with improved outcomes, including shorter ICU stay and lower rates of Dressler's syndrome and rehospitalization.
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