Safety and efficacy analysis of aortic valve replacement through small incision in upper sternal segment

Zhang Hang; Wang Huajun; Wu Xueda; Zhang Jieqiong; Li Luyu; An Jinghui

doi:10.3969/j.issn.1674-4055.2025.02.15

Abstract：Objective To investigate the safety and efficacy of aortic valve replacement through J-shaped small incision in the upper sternal segment.Methods A total of 60 patients undergoing surgical aortic valve replacement in the Department of Cardiac Surgery,Second Hospital of Hebei Medical University from March 2017 to August 2023 were selected,including 30 patients undergoing upper sternal J-shaped small incision aortic valve replacement(minimally invasive group)and 30 patients undergoing traditional total sternotomy aortic valve replacement(traditional group).The time of ascending aorta occlusion,operation time,postoperative mechanical ventilation time,ICU stay time,postoperative drainage volume 24 hours,and the incidence of Major Adverse Cardiovascular Events(MACE)were compared between the two groups.Results There was no significant difference between the minimally invasive and traditional groups in the duration of ascending aorta occlusion and operation(P＞0.05).The postoperative mechanical ventilation time,postoperative ICU stay time,and postoperative 24-hour drainage volume in the minimally invasive group were significantly lower than in the traditional group(P＜0.05).One patient in the minimally invasive group underwent traditional thoracotomy during the operation(considering that it was related to the patient's obesity and exposure difficulties),and there were no deaths in the perioperative period,no cases of secondary thoracotomy after surgery,and no postoperative complications such as poor wound healing.Conclusion Aortic valve replacement through a small incision in the upper sternal segment is safe,effective,and has certain advantages.