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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1998 August;39(4):475-7

lingua: Inglese

“Band Aid” sur­gery: ­upper ­sternal ­split inci­sion for ­valve sur­gery in ­adults. A mod­i­fied tech­nique

Connery C. P.*, Azariades M.**, Prapas S. N.**, Anagnostopoulos C. E.* **

From the * St. ­Luke’s-Roose­velt Hos­pital ­Center, Uni­ver­sity Hos­pital of ­Columbia Uni­ver­sity Col­lege of Phy­si­cians and Sur­geons, New ­York, USA
** Onassis Car­diac Sur­gery ­Center, ­Athens, ­Greece


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A lim­ited 10 cm ­upper ster­notomy to the ­level of the ­third ­right inter­costal ­space ­with pres­er­va­tion of the ­entire ­length of the ­left ­half of the ­sternum (­quarter ster­notomy) ­allows: 1) expo­sure for ­aortic ­valve sur­gery; 2) util­iza­tion of stan­dard equip­ment and can­nu­la­tion tech­niques; 3) pres­er­va­tion of ­both ­internal tho­racic ­arteries and 4) ­early dis­charge ­from the hos­pital. Three ­patients, all ­female, ­aged 45, 62 and 67, two ­with ­severe ­aortic insuf­fi­ciency and one ­with ­severe ­aortic sten­osis, under­went replace­ment. In two, a St. ­Jude’s ­valve and in one, a ­Baxter per­i­car­dial ­valve ­were ­used. In addi­tion, ­aortic decal­cifi­ca­tion-endar­te­rec­tomy was car­ried out in one and re-explo­ra­tion in ­another. All ­patients ­were dis­charged at 4 ­days, ­impressed by ­their “Band-Aid Sur­gery”. ­Improved ­patient ­mobility and ear­lier ­recovery of ven­til­a­tory func­tion are pos­sibly ­related to ­this ­more ­stable ­form of lim­ited ster­notomy.

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