ISMICS Home  |  2022 Virtual Portal  |  Past & Future Meetings
International Society For Minimally Invasive Cardiothoracic Surgery

Back to 2022 Display Posters


Mini-incision Full Sternotomy Aortic Valve Replacement. Short- And Long-term Results On 91 Consecutive Patients
Sotirios Marinakis, Sebastien D'Ulisse, Karim Homsy, Michael El Khoury, Moncef Al Barajjraji, Marc Joris, Badih El Nakadi.
CHU Charleroi, Lodelinsart, Belgium.

BACKGROUND: Minimally invasive procedures for aortic valve replacement are progressively gaining ground over conventional full sternotomy. The most common incision for minimally invasive aortic valve replacement is the partial upper J ministernotomy. Aortic annulus is situated at the level of the fourth to fifth intercostal space which is deeper than our working plane when performing upper J ministernotomy. The aim of this study is to describe our experience with a mini-incision (7cm), full sternotomy approach for minimally invasive aortic valve replacement. Our skin incision was placed at the middle of the sternum, being, after sternum division, exactly at the level of aortic annulus.
METHODS: All patients who benefited from a mini-incision full sternotomy for aortic valve replacement from a single surgeon in our hospital, from January 2013 to December 2018 (n=91) were identified. Baseline demographics, peri, postoperative and laboratory data were extracted from each patient’s medical records.
RESULTS: All, non-redo, aortic valve replacements from January 2013 to December 2018 were performed by the above-mentioned minimal invasive technique by a single surgeon. Continuous variables were reported as median (25%- 75% quartiles) and dichotomous as percentage. Ninety two patients with a median body mass index (BMI) of 27,9 (24,9- 32,8), a euroscore II of 1,8 (1,1- 3,2) and an age of 72 (65- 79) were operated by a single surgeon. The median cross clamp and bypass time was 57 (50- 67) and 81,5 (71- 95,5) minutes. Post-operative and intensive care unit length of stay was 10 (7- 12) and 2 (1-4) days. Thirty days mortality, acute cerebrovascular event and acute myocardial infarction were 2/91 (2,2%), 3/91 (3,3%) and 0/91. One mediastinitis was observed in our series. An up to 8 years Kaplan Meier survival curve is annexed.
CONCLUSIONS: Aesthetics and respect of patient’s integrity is a major motor for minimal invasive surgery. This approach gives better exposure of the aortic valve in comparison to J ministernotomy with a better cosmetic result because skin incision is placed lowest in the thorax. It is easier than J ministernotomy and applicable to all patients, with no preoperative selection criteria, with excellent post-operative outcome.


Back to 2022 Display Posters
By using this site, you agree to our updated Privacy Policy.  Got it