Safety and Efficiency of Mini-Sternotomy versus Standard Sternotomy in Open Heart Surgery for Aortic Valve Replacement

Abstract

Background: For decades, the traditional median sternotomy has been the access of choice in aortic valve surgery; however, numerous researchers have worked to develop less invasive procedures, and the partial upper mini-sternotomy is the most prevalent minimally invasive procedure. Objective: To compare outcomes, in patients who undergo mini-sternotomy, and patients who undergo standard sternotomy, in aortic valve replacement operations. Patients and Methods: This randomized controlled clinical trial study included fifty patients who were admitted to the Zagazig University Hospital, Cardiothoracic Surgery Department in the period between January 2021 to August 2021, Patients were split into two groups, each with 25 patients: Group A had aortic valve surgery by mini-sternotomy, while Group B got aortic valve surgery via traditional surgery. Aortic valve surgery was performed via a conventional median sternotomy in Group B. An ECG was performed to see whether there was any ischemia present, as well as laboratory tests and a chest x-ray. Results: In the present research, there was a significant difference in postoperative outcomes between the mini-sternotomy and complete sternotomy groups in terms of mechanical ventilation and hospital stay. Inotropic support and reopening were not substantially different across groups; however, infection and blood transfusion were strongly linked with the complete group, and neither group had any mortality. Conclusions: Minimally invasive aortic valve replacement, is a safe and effective procedure and is performed with comparable morbidity and mortality to conventional aortic valve replacement (AVR). Minimally invasive aortic valve replacement (MIAVR) results in improved ventilator function, fewer wound infections, shorter hospital stays, and a higher percentage of patients released home early.