Comparison Between Mini-Sternotomy and Full Sternotomy for Aortic Valve Replacement: A 10-Year Retrospective Study.

Abstract

Introduction Aortic valve replacement (AVR) is a mainstay treatment for moderate to severe aortic valve stenosis. This retrospective study aimed to compare the clinical outcomes of mini-sternotomy and conventional sternotomy. Methodology This 10-year retrospective study compared the clinical outcomes of mini-sternotomy and full sternotomy. Patient-related outcomes include sternal wound dehiscence, operative time, length of hospital stay, and Intensive Care Unit (ICU) stay, whereas intraoperative parameters such as cardiopulmonary bypass (CPB) time and Aortic Cross Clamp time (ACCt) were compared between the two treatment groups. Results A total of 371 patients underwent AVR. Among them, 238 patients had AVR with full sternotomy and 133 patients had a mini-sternotomy. Full sternotomy patients had significantly lower bleeding than those in the mini-AVR group (p-0.002). The operation time was also found to be significantly higher in the mini-AVR group. The duration of hospital stays, ICU stay, and deep sternal wound dehiscence were recorded to be statistically insignificant between the two treatment groups. Atrial fibrillation, sternal wound dehiscence, stroke and perioperative myocardial infarctions, were equally observed between the two groups. Conclusion Mini-sternotomy is a safe option for AVR. The same number of complications were observed between the two groups; however, there was a reduction inthe duration of hospital stay and ICU stay amongst the mini-sternotomy group.