Ascending Aorta With Or Without Valve Surgery Through Upper Mini-sternotomy Approach
Hailong Cao, Dongjin Wang, Qing Zhou, Jun Pan, Bomin Zhang, Yunxing Xue.
Nanjing Drum Tower Hospital, Nanjing, China.
Background: Upper mini-sternotomy is a routine approach for single aortic valve surgery, but the usage for aortic surgery is not well established. Methods: From January 2015 to December 2018, 54 cases underwent aortic surgery with or without valve procedure in our center. The sternotomy was constructed through a 6-8 cm “J-shape” incision from superior sternum fossa to 3rd/4th/5th intercostal space. The arterial cannulation was through ascending aorta or femoral artery, the venous cannulation was through right atrium. HTK solution for cardioplegia. Among 54 cases, 20 were Bentall procedure, 22 were Wheat procedure and 12 others were AVR and ascending aorta plasty. Results: The mean age was 51.7±5.9 years, 68.5% were male. The preoperative diameter of ascending aorta and aortic sinus were 56.0±18.0 and 41±9.8 mm, respectively. The preoperative EF was 52.7±9.0% (38-59%). The average CPB, clamp time was 176±59.1 and 117±46.6 min, respectively. The 30-day mortality was 1.9% (1/54). The volume of drainage was 390±180 ml. Conclusions: Our experience revealed that upper mini-sternotomy is a safe and effect approach for ascending aortic surgery with less invasive injury. 
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