Less invasive cardiac operations through a median sternotomy: 100 consecutive cases

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Surgery

Background:

• Developed a routine approach for intracardiac operations using a less invasive median sternotomy.
• Utilized a limited skin incision (6-9 cm) and subcomplete median sternotomy for easier chest opening/closing.
• Employed conventional central cardiopulmonary bypass without surgical technique modifications.

Purpose of the Study:

• To evaluate the feasibility and outcomes of a less invasive median sternotomy approach for cardiac operations.
• To assess the benefits of reduced trauma, pain, and infection risk in cardiac surgery patients.
• To determine if this modified sternotomy leads to earlier patient discharge.

Main Methods:

• Performed 100 consecutive cardiac procedures (aortic, mitral, and other) using the modified sternotomy.
• Required specialized self-made instruments for the surgical technique.
• Implemented anesthetic fast-tracking management for patients.

Main Results:

• Achieved a shorter scar length (<9 cm) in all patients.
• Observed a shorter postoperative course with one wound healing complication.
• Reported four deaths, one conversion to standard sternotomy, and five reoperations for bleeding.

Conclusions:

• A modified median sternotomy is a viable, less invasive approach for various cardiac operations.
• This technique offers advantages including reduced patient trauma, pain, infection risk, and blood loss.
• Patients undergoing this procedure experience earlier extubation and hospital discharge.