Aortic valve replacement outcome using upper ministernotomy: A prospective comparison of the upper ministernotomy and conventional full median sternotomy

Abstract

Atsushi Tamura, Hiroko Nakata, Tetsuya Sato, Takamichi Yoshizaki

Objectives: The prevalence of aortic valve disease is increasing. The purpose of this study was to compare the outcomes of patients undergoing ministernotomy versus conventional full sternotomy for aortic valve replacement (AVR). Materials and Methods: Between May 2009 and November 2013, 59 consecutive patients underwent AVR in our institution; 27 patients received upper ministernotomy (Group M), and 32 received conventional median full sternotomy (Group F). Pre-operative characteristics, aortic valve pathology, and left ventricular function in both groups were similar. Results: No differences were found in mean operation time, volume of blood loss, mean cardiopulmonary time, aortic clamp time, transfusion rate, or mortality and morbidity rates. However, the amount of red blood cells used in transfusion was significantly less in Group F than in Group M (7.3 ± 4.5 vs. 4.6 ± 3.3 units, P = 0.015). Conclusions: Although ministernotomy can be safely used for AVR without prolonging operative or cardiopulmonary time, no significant advantages were discerned for choosing ministernotomy over conventional full median sternotomy.