Comparison of minithoracotomy with conventional sternotomy methods in valve surgery

Background: To determine the differences in the operative findings between the two groups of patients who had undergone either minithoracotomy or conv entional sternotomy. Methods: We compared 12 valve operations that were performed in our clinic with minithoracotomy (group I) between January 1997 and November 1999 with 13 valve operations that were performed with conventional median sternotomy (group II) in the same period in regard to preoperative, perioperative and postoperative variables, retrospectively. Preoperative variables were age, sex, bleeding time, clotting time, platelet count, and additional diseases like diabetes mellitus, hypertension, etc. Perioperative variables were ex tracorporeal circulation (ECC) time, cross-clamp (CC) time, and operation t ime. Postoperative variables were mechanical ventilation period, stay in th e postoperative intensive care unit and hospital, mediastinal drainage amou nt, the amount of blood and blood products for transfusions, and costs. Gro up I consist of six mitral valve replacements (MVRs), three aortic valve re placements (AVRs), one aortic valve replacement combined with mitral valvul oplasty, and two tricuspid valve replacements (TVRs). Group II consist of n ine MVRs and four AVRs. Results: Statistical results are given with mean standard error (SEM) devia tions. There were significant differences between the two groups in respect to operation time tin group I, mean operation time was 328 +/- SEM 22 minu tes in group II, 271 +/- SEM 14 minutes (p < 0.04)); mediastinal drainage t in group I, mean drainage time was 283 +/- SEM 57 cc/m(2), in group II, 490 +/- SEM 74 cc/m(2) (p < 0.04)); and amounts of transfused blood and blood products tin group I, mean transfused blood products amount was 375 +/- SEM 115 cc/m(2), in group II, 874 +/- SEM 184 cc/m(2) (p < 0.03)). Conclusion: The operation times are apparently longer in the minithoracotom y group. On the other hand, less mediastinal drainage occurred and less blo od and blood products transfusion needs were determined to exist in the min ithoracotomy group.