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Eur J Cardiothorac Surg 1998;14:S115-S116
© 1998 Elsevier Science NL

A new approach to cardiac valve replacement through a small midline incision and inverted L shape partial sternotomy ¹

^a Department of Cardiac Surgery, University Hospital 12 de Octubre, Madrid, Spain
^b Department of Anesthesiology, University Hospital 12 de Octubre, Madrid, Spain

^* Corresponding author. Servicio de Cirugía Cardíaca. Ctra. de Andalucia Km 5400 Hospital Universitario 12 de Octubre, 28041 Madrid, Spain. Tel.: +34 91 3908321/3908396; fax: +34 1 3908396.

Objective: Minimally invasive cardiac surgery is becoming more popular as an alternative technique in some cardiac operations. We report our experience with an inverted `L' ministernotomy in 25 patients and describe the technical details of this new approach. Methods: From June 1996 to February 1997 we performed 25 ministernotomy approaches for cardiac surgery, 17 aortic and 7 mitral valve replacements and 1 atrial septal defect closure. A comparison group included all patients (n=126) operated on for mitral or aortic valve replacement through a median sternotomy since June 1996. Results: Ventilatory support, Intensive Care Unit stay and hospital stay were 8.3 h (SD=4 h), 25 h (SD=8 h) and 5.5 days (SD=3 days) in the L ministernotomy group and 11.5 h (SD=5), 53 h (SD=11) and 9.1 days (SD=4 days) in the median sternotomy group (P<0 05). Mortality and morbidity are similar to conventional sternotomy (hospital mortality 4% vs. 5.5%; P not significant). Conclusions: We conclude that inverted L ministernotomy for cardiac surgery is a safe approach and can offer some advantages over the conventional approach.

Key Words: Ministernotomy • Cardiac surgery

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