الفهرس | Only 14 pages are availabe for public view |
Abstract OBJECTIVES: comparison between aortic valve replacement (AVR) through full sternotomy versus ministernotomy as regards efficiency and complications. PATIENTS & METHODOLOGY: There were sixty patients with aortic valve disease 30 patients became group“A” underwent AVR through ministernotomy, other 30 patients became group “B” underwent full sternotomy. Data were collected preoperatively, Intraoperatively and postoperatively and compared. Aortic cannulation, venous cannulation and antegrade blood cardioplegia were the same in both groups. RESULTS: There were no statistical differences between the two groups preoperatively. There were few complications occurred in both groups with no mortality. In full sternotomy group, total bypass time was shorter with significant difference. However, total operative time had no statistical significant differences between the two groups. In ministernotomy group, total hospital stay, intensive care unit stay, mediastinal bleeding, ventilatory time, blood transfusion was less, with better cosmosis and more patient satisfaction. CONCLUSIONS: Ministernotomy AVR present accepted exposure of the aortic valve but narrow operative field that induce longer operative times. In addition, it is as safe as full sternotomy, with no statistical significant differences as regards post-operative complications. Ministernotomy approach had less hours of ventilation, significantly less amount of mediastinal drainage, less intraoperative and postoperative blood transfusions, less ICU and hospital stay and less postoperative pain allowing faster rehabilitation .Moreover, provide cosmetically better wound that was strongly satisfy patients. We advise to use ministernotomy incision as an initial approach for isolated AVR. |