UPPER-T MINI-STERNOTOMY FOR AORTIC-VALVE OPERATIONS

Objectives: New minimally invasive approaches for cardiac surgical pro cedures are constantly being developed in the hope of decreasing patie nt morbidity and enhancing the postoperative recovery. This report rev iews the use of an upper T mini-sternotomy approach to aortic valve su rgery. Patients: Nine consecutive nonselected patients (5 men, 4 women , mean age, 66 years) underwent isolated aortic valve replacement with the use of this approach. Two patients had isolated aortic valve sten osis, three had isolated aortic valve incompetence, and four patients had mixed aortic valve disease. Results: In all cases, an excellent vi ew of the aortic valve was obtained, aortic valve replacement with a b ileaflet mechanical prostheses was performed, and no intraoperative di fficulties were encountered. Mean aortic cross-clamp time was 83 min a nd mean cardiopulmonary bypass perfusion time was 97 min. All patients were extubated in the operating room at the end of the surgical proce dure, and there were no postoperative complications. All patients were discharged home on postoperative day 3, and there were no late compli cations. Conclusion: Through an upper T mini-sternotomy, aortic valve surgery can be performed in the conventional manner using standard sur gical instruments with no alteration in cardiopulmonary bypass and myo cardial protection routines. With this method, postoperative pain is r educed and patient recovery is expeditious.