ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
A comparison of lower ministernotomy (manubrium-sparing sternotomy) and standard median sternotomy in coronary artery bypass surgery
Ugur Kaya, Abdurrahim Çolak, Münacettin Ceviz, Necip Becit, Hikmet Kocak
Department of Cardiovascular Surgery, Medical Faculty of Ataturk University, Erzurum, Turkey
DOI : 10.5606/tgkdc.dergisi.2017.14661
Background: In this study, we aimed to compare early outcomes of lower ministernotomy (manubrium-sparing sternotomy) and standard median sternotomy in coronary artery bypass grafting surgery.

Methods: Between January 2015 and December 2016, a total of 28 patients (15 males, 13 females; mean age 64.5±10.1 years; range 43 to 82 years) who underwent coronary artery bypass grafting surgery at the Department of Cardiovascular Disease were retrospectively analyzed. Of these patients, 14 patients were operated with lower ministernotomy (manubrium-sparing sternotomy; group 1) and 14 patients were operated using standard median sternotomy (group 2). Data including age, gender, body surface area, preoperative clinical findings, intraoperative variables, postoperative complications, the amount of transfusion products, hemoglobin and hematocrit values, drainage volumes, intubation duration, mortality, and length of intensive care unit and hospital stay of both groups were compared retrospectively.

Results: There was no statistically significant difference in the crossclamp time, cardiopulmonary bypass time, and total procedure time between the groups. There was a statistically significant difference in the amount of chest tube drainage, the need for blood transfusion which was lower in the ministernotomy group, and postoperative hematocrit levels, postoperative hemoglobin levels and postoperative SaO2 levels which were higher in the ministernotomy group. There was a statistically significant difference in the ventilation time and length of stay in the intensive care unit and hospital in favor of the ministernotomy group. The study showed no statistically significant difference in the mortality rate between the two groups.

Conclusion: Our study results show that the manubrium-sparing sternotomy may be a feasible alternative to surgery through classical median sternotomy for, particularly, patients who are obese, diabetic, and have poor respiratory functions.

Keywords : Coronary artery bypass grafting; minimally invasive surgical procedure; sternotomy
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