Superior partial median sternotomy during minimal invasive valve operation

Ji Wei; ZHOU Xiao-hui; WANG Shui-yun; WEI Zhi-ling; CUI Peng; FANG Dan

doi:10.3760/cma.j.issn.1673-4777.2013.08.011

Abstract：Objective To analyze the technical progress and the clinical effect of the superior partial median sternotomy(SPMS) approach of heart valve surgery.Methods From October 2012 to February 2013,20 patients undergoing heart valve surgery through a SPMS approach were selected as minimal incision group,and 20 cases underwent heart valve surgery through a conventional sternotomy was the conventional group.There were 12 male and 8 female patients in the minimal incision group,with average age of (51 ± 15) years and average weight of (66 ± 11) kg.There were 16 male and 4 female patients in the conventional group,with average age of (57 ± 10) years and average weight of (65 ± 12) kg.Total operation duration,cardiopulmonary bypass duration,aortic cross-clamping duration,intensive care unit stay,ventilation time,amount of drainage,blood transfusion volume and postoperative hospital stay were observed and compared between the two groups.Results There were no cases of in-hospital death.There was no re-exploration for postoperative bleeding,complete atrioventricular block,embolism or perivalvular leakage in both groups.All patients in the minimal incision group with preoperative sinus rhythm remained in sinus rhythm postoperatively.Chest drainage in postoperative 24 hours in the minimal incision group was significantly less than that in the conventional group[(345 ± 160) ml vs (436 ± 101) ml,P =0.036].Red blood cells transfusion volume in the minimal incision group was significantly less than that in the conventional group[(1.6 ±1.4) U vs (3.2 ±2.7) U,P=0.029].Conclusion As a safe and reliable procedure,SPMS approach can reduce the surgical injury and achieve good early outcomes with a low volume of blood transfusion.