Ministernotomy Versus Standard Sternotomy for Aortic Valve Replacement

Minimally invasive aortic valve surgery is becoming more popular everyday. The most used approach is mini-sternotomy. There are several promoted benefits related with minimal invasive approaches in comparison with standard sternotomy. This study aimed to compare the early postoperative results of mini-sternotomy and standard sternotomy.

This is a retrospective study that compares minimal invasive with conventional sternotomy aortic valve surgery in terms of early results. The patients underwent surgery at the University Hospital Center "Mother Theresa", Tirana, Albania between July 17, 2017, and July 30, 2024. The data were collected from hospital registration. All data are presented as mean ± standard deviation. Key outcomes included early mortality, perioperative complications, and intraoperative and postoperative recovery times.

The study included 168 patients (95 males, 73 females) with a mean age of 62 ± 12.5 years. Standard sternotomy was used in 115 patients with a mean age of 63.93± 9.52 and mini-sternotomy was used in 53 patients with a mean age of 62.97 ± 10.47 without differences between them (P=0.633). The overall mortality was 1.2 % (four patients). There were no significant differences in mortality and incidence of perioperative complications between the two groups. The minimally invasive group had shorter intensive care unit (ICU) stay (39.92 ± 8.62 hours vs. 55.96 ± 32.56 hours, p < 0.001) and mechanical ventilation assistance duration (5.82 ± 2.44 hours vs. 10.41 ± 14.68 hours, p = 0.030).

The minimally invasive aortic valve replacement through mini-sternotomy is as safe as standard sternotomy. Mini-sternotomy clearly is related to significant shorter ICU stay time and mechanical respiratory assistance that can be traduced in lower hospital cost.