ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
MERT Murat, ÇETİN Gürkan, BAKIR İhsan, ERENTÜRK Selim, AYGUTALP Nadir, BİLAL Mehmet Salih
İstanbul Üniversitesi, Kardiyoloji Enstitüsü, Kalp ve Damar Cerrahisi Anabilim Dalı, İSTANBUL
The new trend in open heart surgery is to perform cardiac operations with very small and limited incisions. The feasibility of a large spectrum of cardiac operations by these approaches with or without using cardiopulmonary bypass with the same success as conventional sternotomy approach is reported by many centers. The mini-thoracotomy and the mini-sternotomy incisions are the more populars among these new approaches. 18 patients with very different cardiac pathologies were operated using superior or inferior sternotomy incisions. With superior mini-sternotomy, 7 patients (6 aortic and/or mitral valve replacement procedures and 1 aortopulmonary window repair) and with inferior mini-sternotomy, 11 patients (6 patients for the correction of congenital cardiac pathologies 1 patient for mitral valve replacement and tricuspid valve repair and 4 patients for left internal thoracic artery grafting to the left anterior descending coronary artery on beating heart) were operated. There was no mortality in the study group. The mean time for extubation was 10,3 (±6,0) hours, surgical intensive care unit stay was 1,3 (±0,5) days and total hospital stay was 6,6 (±1,7) days. Postoperative incisional problems were not encountered in any of the patients. Postoperative pain complaints of this mini-sternotomy group were less than the patients operated by the conventional median sternotomy approach and the postoperative activation was more earlier with a more acceptable cosmetic result of the incision. The successful results of the patients operated by the mini-sternotomy approach, the decrease in the extubation, intensive care unit stay and hospital stay times together with a better cosmetic result and the comfort of the surgeon to be able to transform the incision to the conventional sternotomy without a change in the patient’s position any time needed enables us to think that mini-sternotomy approach should be considered in a majority of cardiac operations.
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