CASE REPORTS  CARDIAC PAPERS 

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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

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.