Is right mini-thoracotomy preferable to intermediate sternotomy in mitral valve surgery? | ||||
| Zagazig University Medical Journal | ||||
| Article 14, Volume 29, Issue 1, January 2023, Page 113-119 PDF (357.37 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2022.147806.2597 | ||||
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| Authors | ||||
Amr Mansour  1; Mamdouh Elsharawy1; Tamer Salem Alawady2; waleed abdallah sherif3; Mohamed Salah Abdelbasit 4; Mohamed I. Alanwer5
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| 1Department of Cardiothoracic surgery, Zagazig University, Egypt | ||||
| 2cardiothoracic surgery department, faculty medicine, zagazig university, zagazig, egypt | ||||
| 3cardiothoracic surgery department Zagazig university, Egypt | ||||
| 4Cardiology zagazig university | ||||
| 5Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig , Egypt. | ||||
| Abstract | ||||
| Median Sternotomy was used to execute mitral valve surgeries. Minimally invasive mitral valve surgery (MVS) through right mini-thoracotomy has lately received a great deal of interest. The major aim of this study was to evaluate clinical outcome of anterior thoracotomy compared to traditional median sternotomy for mitral valve replacement.Results: A statistically significant difference was found in cross-clamp time between the two groups. Cross-clamp time was higher in group II (67.2 ± 5.6 minutes) than group I (46.05 ± 4.7 minutes). Total bypass time was higher in group II (86.2 ± 5.7 hours) than group I (75.5 ± 5.1 hours). Also, total operating time was higher in group II (276.2 ± 5.6 minutes) than group I (238.1 ± 5.6 minutes). A significant discrepancy was found between VAS scores in the two groups in the 1st and 2nd day and time to return to normal activity that were higher in group I than group II. Hypertrophic scar was found in 21 patients (28.7%) of group I and 7 patients (9.5%) in group II with statistically significant difference. 24 patients in group I (32.8 percent) and 68 patients in group II (93.1 percent) were happy with the look and aesthetic quality of their scars. Conclusions: minimally invasive right anterolateral thoracotomy has a longer cross-clamp duration, total bypass time, and total operating time than the standard median sternotomy, but it is a viable option. It results in less bleeding, less discomfort, a shorter hospital and ICU stay, and a quicker recovery. | ||||
| Keywords | ||||
| Mitral valve replacement; Sternotomy; Thoracotomy; Anterior; Median | ||||
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