Minimal-access aortic and valvular operations, including the "J/j" incision

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Surgical Incisions

Background:

• Comparison of five minimal-access surgical approaches against standard incisions for cardiac operations.
• Evaluation of parasternal incision, transverse sternotomy, manubrial inverted "T" incision, incomplete mediastinotomy, and the novel "J/j" incision.

Purpose of the Study:

• To assess the efficacy and patient outcomes of various minimal-access cardiac surgery incisions.
• To compare the "J/j" incision with other minimal-access techniques and standard sternotomy.

Main Methods:

• A case-control study involving 74 patients undergoing various cardiac operations (aortic valve, composite valve graft, ascending aorta, etc.).
• 37 patients received minimal-access operations, matched with 37 controls having standard incisions.
• The "J/j" incision involved sternotomies from the first right intercostal space to the third to fifth right intercostal space.

Main Results:

• Minimal-access surgery patients experienced shorter postoperative hospital stays (6.2 vs. 8.2 days).
• The "J/j" incision group showed significantly reduced morphine use (20.6 vs. 40.9 mg) and the shortest hospital stay (5.1 days).
• No strokes or neurocognitive deficits were observed; one death occurred due to adult respiratory distress syndrome in the minimal-access group.

Conclusions:

• Minimal-access incisions are linked to shorter hospital stays in cardiac surgery.
• The "J/j" incision demonstrates potential for reduced postoperative pain and earlier patient discharge, even in complex procedures.