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Aortic Valve Replacement Using J-Upper Hemisternotomy
Abdusalom Abdurakhmanov, Shahboz Buranov;
Republic Research Center Of Emergency Medicine, Tashkent, Uzbekistan
BACKGROUND: analyzing the first results of aortic valve replacement through the J-hemisternotomy.
METHODS: the study included 50 patients who underwent aortic valve replacement during the period 2022-2023. The patients were divided into 2 groups; the first group - 40 patients - access was carried out from a standard sternotomy, the second group - 10 cases - from a J hemisternotomy. In the first group there were 30 male patients; female - 10; in the second group there were 8 male and 2 female patients.
RESULTS:There were no significant differences in the duration of aortic cross-clamping time (45±3.2 and 44±9.8 minutes, respectively). However, the duration of CPB in the mini-sternotomy group was significantly longer due to the need for drainage and suturing of myocardial electrodes on CPB (75±3.6 and 90±10.2 minutes, respectively). In both groups, mechanical valves were implanted more often (32(80%) and 7(70%), respectively, in the first and second groups. A significantly shorter period of pulmonary ventilation and duration of hospital stay and lower postoperative drainage were observed in the mini-AVR group (p < 0.05). Patients in the mini-sternotomy group reported less postoperative pain. number of transfused blood units. There were no differences in the frequency of postoperative complications such as mortality, stroke, atrial fibrillation, renal failure, wound infection, sternal instability, or the need for rethoracotomy.
CONCLUSIONS: J-upperhemisternotomy for AVR is a safe method and does not increase morbidity and mortality. It significantly reduces post-operative blood loss and shortens hospital stay. Ministernotomy can be successfully used as an alternative method to sternotomy.
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