Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
2760141 | Journal of Cardiothoracic and Vascular Anesthesia | 2009 | 7 Pages |
ObjectiveThe purpose of this study was to compare the respiratory function of patients operated either with a ministernotomy or with a conventional sternotomy for an aortic valve replacement.DesignA prospective randomized study.SettingA single-institution university hospital.ParticipantsSeventy-eight patients scheduled for aortic valve replacement.InterventionsPatients were assigned to have minimal sternotomy access (ministernotomy) or conventional median total sternotomy. Pulmonary function was measured using a mobile respiratory spirometric device preoperatively and after 1 (POD1), 2 (POD2), and 7 days (POD7) postoperatively.Measurements and Main ResultsThere was no significant difference in any respiratory parameter measured between the 2 groups of patients. Almost all respiratory volumes decreased significantly with the same intensity in the 2 groups on POD1 (p <0.05), by about 50% from baseline. Only functional residual capacity was unchanged from baseline in the postoperative period, except for a small but significant reduction of this parameter to 60.3% ± 27.4% in the standard sternotomy group on POD1 and 60.9% ± 27.1% and 58.8% ± 30.4%, respectively, in the ministernotomy and the standard group at POD7. The only significant difference concerned the intraoperative blood loss measured at 450 ± 280 mL and 720 ± 450 mL, respectively, in the ministernotomy and the standard group (p < 0.05), but this was not significantly associated with a reduction of total blood use.ConclusionThis study failed to show any improvement of respiratory function by a smaller chest incision. However, it showed a significant reduction in intraoperative bleeding but without a reduction in transfusion. Further investigations are required to assess whether this procedure could improve the outcome of cardiac surgery patients with a greater predicted risk score or pulmonary diseases.