Compartive Study Between Aortic Valve Replacement Through Full Sternotomy Versus Ministernotomy

Abstract

Because of the continuous trend towards less invasive procedures, cardiac operations have become increasingly more sophisticated and complex, minimally invasive techniques in cardiac operations require higher surgical abilities to accomplish the same quality compared with the traditional procedures with cardiopulmonary bypass or sternotomy. This study was to compare the procedure and early postoperative outcome of the standard sternotomy approach with the minimally invasive approach through limited upper ministernotomy This study was conducted on 60 patients. All the patients completed the study without mortality. The patients were classified into 2 groups: • Group A: Minimally invasive group. This group included 30 patients requiring aortic valve surgery. The surgical approach was through the limited upper ministernotomy (6-10 cm). • Group B: Sternotomy group. This group included 30 patients requiring aortic valve surgery. Through a conventional median sternotomy (19-25cm). There was no statistically significant difference as regards the age, sex, NYHA, preoperative echocardiographic findings. Regarding intraoperative comparison, there was statistically significant difference in the total bypass time that was longer in group “A”. This difference was due to the new experiences in this minimally invasive technique and the crowdedness of instrumentation in that narrow field of the ministernotomy. The length of the skin incision was highly significantly lesser in group “A” than in group “B”. There was highly significant difference in the intensive care parameters. The mechanical ventilation time was shorter in group “A”, the blood loss and the blood transfusion required was lesser in group “A”. The ICU stay was shorter in group “A”. There was significantly less postoperative pain in group “A” than in group “B”. Total hospital stay was less in group “A” than in group “B”. The package cost effective was much more in group “A” than group “B”.