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Eur J Cardiothorac Surg 1998;14:S134-S137
© 1998 Elsevier Science NL

Minimally invasive aortic valve replacement via hemi-sternotomy: a preliminary report ¹

Department of Cardiac Surgery, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, 4032 Australia

^* Corresponding author. Tel.: +61 07 33508904; fax: +61 07 33508426; e-mail tamr@health.qld.gov.au

Objective: Aortic valve replacement has been approached by standard sternotomy. We described a technique of aortic valve replacement where the aortic valve is exposed through a hemi-sternotomy. Good exposure is obtained for aortic valve surgery with standard aortic and right atrial cannulation to establish cardiopulmonary bypass (CPB). Methods: From October 1996 to April 1997, 19 consecutive aortic valve replacements (AVR) via hemi-sternotomy were performed by one surgeon. The results were collected and analysed prospectively. Results are expressed as mean±standard deviation. Nineteen patients (13 male, 6 female) had AVR with this approach. Two cases were re-do AVR. The mean age was 58±15 years. The New York Heart Association (NYHA) class was 2.8±0.7. Results: Aortic cross clamp time was 54±13 min. One of six patients requiring defibrillation after reperfusion needed conversion to full sternotomy. Four patients were extubated at the conclusion of surgery. One patient died 4 h postoperatively from low cardiac output. All patients had normal valvular function demonstrated on postoperative transoesophageal echocardiography. There were no neurological events. Conclusions: Minimally invasive aortic valve replacement can be safely performed via hemi-sternotomy with standard equipment. Less surgical trauma to the sternum has the potential benefit of less pain and shorter intensive care and hospital stay.

Key Words: Minimally invasive aortic valve replacement • Hemi-sternotomy