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KMID : 0364019990320040379
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Korean Journal of Thoracic and Cardiovascular Surgery
1999 Volume.32 No. 4 p.379 ~ p.382
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Minimally Invasive Cardiac Surgery -Lower half sternotomy-
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Choi Kang-Joo
Kim Byung-Hun
Lee Yang-Haeng
Hwang Youn-Ho
Cho Kwang-Hyun
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Abstract
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Background: There are several advantages to the ministernotomy approach. The skin incision is much smaller than the traditional median sternotomy incision. This approach allows the patients to return to normal life more quickly and provide them
with good self-image.
Material and Method: From April to July 1998, we performed a ministernotomy via lower half sternum in 25 patients. There were 10 males(40%) and 15 females(60%) with a mean age of 30±16 years(range 3 to 55 years). The body surface area ranged
from 0.58 to 1.9 ㎡(mean 1.5 to 0.4 ㎡). A vertical skin incision of 11㎝ in mean length was made in the midline over the sternum extending inferiorly from the third intercostal space. The sternum was divided vertically in the midline from the xyphoid
process to the level of second intercostal space using a standard saw and then transversely to the left(n=17) or to both sides(n=4) of the second intercostal space using an oscillating saw. The sternum was divided vertically only in children (n=4).
Result: The ministernotomy was used in 25 consecutive patients undergoing mitral valve replacement(n=10), repair of ventricular septal defect(n=4) and atrial septal defect(n=11). There was no significant complication related to ministernotomy.
The mean ICU stay time 20 hours. Patient and family acceptance was very high.
Conclusion: We concluded that minimally invasive cardiac surgery via ministernotomy can be done safely. These methods may benefit the patients with lesser discomfort, smaller incision, and earlier ICU discharge than the traditional incision.
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